title: [Mini-Mental State Examination in geriatrics : An evaluation of diagnostic quality].
abstract: BACKGROUND
  Several studies have identified moderate reliability and validity for the Mini-Mental State Examination (MMSE). Some researchers showed the superiority of other dementia screening tests over the MMSE considering the test quality criteria. The aim of this study was the evaluation of MMSE, especially in the area of geriatrics.
  
  
  METHODS
  MMSE and DemTect were carried out with 154 geriatric patients: 71 persons without cognitive impairment and 83 persons without delirium showed cognitive impairments as revealed by the DemTect. In addition, we also applied the Clock-Drawing-Test (CDT), Reisberg-Scale, Geriatric Depression-Scale (GDS, 15-item version) and the Confusion-Assessment-Method (CAM).
  
  
  RESULTS
  According to the multitrait-multimethod approach, MMSE's convergent and divergent validity is similar to that of the DemTect. Both tests correlate only moderately with Spearman (r = 0.609) and revealed similar results for dementia in 57.1 % of the patients. MMSE showed low reliability and moderate reliability (Cronbach's α = 0.82) when ten items with low discriminatory power were excluded from the total test score. Difficulty of all items is only moderate (p = 0.86) and only eight items of the MMSE showed good test difficulty.
  
  
  CONCLUSIONS
  All in all, DemTect and MMSE are not interchangeable. The MMSE estimates the average cognitive impairment of patients as considerably less pronounced than the DemTect. MMSE is, thus, not an instrument that would be recommended for the identification of mild cognitive impairment. In this case, tests with higher reliability and validity should be used.
authors.affiliation: Zentrum für Geriatrie und Orthopädie, Otto-Fricke-Krankenhaus Paulinenberg GmbH, Martha-von-Opel-Weg 34, 65307, Bad Schwalbach, Deutschland, Stefanie.Beyermann@otto-fricke-krankenhaus.de.
authors.forename: S
authors.initials: S
authors.lastname: Beyermann
authors.forename: R H
authors.initials: RH
authors.lastname: Trippe
authors.forename: A A
authors.initials: AA
authors.lastname: Bähr
authors.forename: R
authors.initials: R
authors.lastname: Püllen
mesh_terms: D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications* / Q000175:diagnosis*; D003704:Dementia / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D005858:Germany; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index