Derivation and validation of a Short Form of the Mini-Mental State Examination for the screening of dementia in older adults with a memory complaint.
OBJECTIVE
To validate a Short Form of the Mini-Mental State Examination (SMMSE) as a screening test for dementia in older ambulatory individuals followed in a memory clinic for a memory complaint.


METHODS
A total of 202 cognitively healthy individuals, 100 individuals with a mild cognitive impairment and 304 demented individuals sent for a memory complaint by their primary care physician to a memory clinic were prospectively included in this cross-sectional study. They were randomized into derivation (n = 303) and validation (n = 303) groups. The SMMSE score was built from six memory items of MMSE, with a score ranging from 0 to 6 (i.e. best performance).


RESULTS
The receiver operating characteristic curve showed an area under the curve of 0.98 for the derivation group and 0.97 for the validation group without differences between curves (P = 0.254). The cut-off between the sensitivity and the specificity of the SMMSE score for clinically diagnosed dementia was ≤4. The performance of the SMMSE for the diagnosis of dementia was high in the derivation and validation groups: sensitivity at 93.1% and 93.8%, specificity at 93.8% and 90.5%, positive predictive value at 94.3% and 90.1%, negative predictive value at 92.5% and 94.0%, likelihood ratio of positive test at 14.9 and 9.8 and of negative test at 0.07 and 0.07, respectively.


CONCLUSIONS
The Short Form of the Mini-Mental State Examination was a good screening test for dementia in older individuals followed in a memory clinic for a memory complaint. The next step should be the confirmation of its discriminative value in older primary care patients.
Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France.
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G
Haubois
Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France.
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L
de Decker
Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France.
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C
Annweiler
Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France.
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C
Launay
Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Geneva University, Geneva.
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G
Allali
Department of Rehabillitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
F R
FR
Herrmann
Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France.
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O
Beauchet
D000368:Aged; D019540:Area Under Curve; D003704:Dementia / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology*; D009483:Neuropsychological Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity