[Test-retest and interobserver reliability of a Spanish version (MMSE-37) of the Folstein minimental test, adapted to populations with a low level of schooling].
BACKGROUND
Several versions of Folstein's minimental test (MMSE, Minimental State Examination) exist in Spanish. One of them is the 37-point MMSE (MMSE-37), which is adapted to people with a low cultural level. AIM. To study the interobserver and test-retest reliability of the MMSE-37.


METHODS
Interobserver reliability was studied in three professional observers who simultaneously administered the MMSE-37 to 40 patients from a community setting. Test-retest reliability was obtained in 35 patients by administering the MMSE-37 on two occasions 2-3 months apart. Statistics used: intraclass correlation coefficient (ICC), Bland-Altman difference plot method, and kappa index.


RESULTS
Interobserver reliability study: multiple ICC of 0.99 (95% confidence interval, CI 95% = 0.99-0.99); kappa index of 0.84 (CI 95% = 0.72-0.97); the degree of agreement between the individual responses was 1 for 'pathological outcome', 0.79 for 'probably pathological outcome', 0.37 for 'probably normal outcome' and 0.89 for 'normal outcome'; ICC > 0.99 (CI 95% = 0.99-0.99) between all the pairs of observers. The systematic differences in the mean score between the pairs of observers did not exceed the score of 0.1, which represents a bias of 0.47% after removing the scale. Test-retest reliability study: ICC of 0.92 (CI 95% = 0.87-0.96), kappa index of 0.84 (CI 95% = 0.54-1.00) and mean difference in the magnitude of disagreement of 0.34 (CI 95% = -2.80-3.49), 1% of the percent error in the magnitude of the disagreement.


CONCLUSIONS
The MMSE-37 shows a high degree of test-retest reliability and reliability among professional observers, as in other versions of the MMSE.
Centro de Salud Comillas, Madrid, España.
Esther
E
Tapias-Merino
Verónica
V
Puertas-Martín
Carolina
C
Vera-García
David
D
Lora-Pablos
Antonio
A
Revuelta-Alonso
Félix
F
Bermejo-Pareja
D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards* / Q000706:statistics & numerical data*; D015588:Observer Variation; D015203:Reproducibility of Results; D013030:Spain