title: The Mini-Mental State Exam (MMSE) is not sensitive to cognitive impairment in bariatric surgery candidates.
abstract: BACKGROUND
  Cognitive dysfunction is common among bariatric surgery candidates and associated with poorer weight loss outcomes. Identification of a brief screening measure to detect cognitive impairment in this population is needed, because comprehensive neuropsychological evaluations may not be available in all clinical settings.
  
  
  METHODS
  The present study examined the utility of the Mini-Mental State Examination (MMSE) for detecting cognitive impairment in 30 bariatric surgery candidates by comparing impairment on the MMSE (at varying cutoffs) to impairment on a comprehensive neuropsychological test battery.
  
  
  RESULTS
  Results indicated that the MMSE showed low sensitivity and specificity in identifying impairment, even at the more stringent MMSE cutoffs of 27 and 28.
  
  
  CONCLUSIONS
  These findings suggest that the MMSE is a poor screener for cognitive impairment in bariatric surgery candidates. Future research is needed to identify or develop cognitive screeners for use in this population.
authors.affiliation: Kent State University, Kent, Ohio.
authors.forename: Rachel
authors.initials: R
authors.lastname: Galioto
authors.affiliation: Kent State University, Kent, Ohio.
authors.forename: Sarah
authors.initials: S
authors.lastname: Garcia
authors.affiliation: Kent State University, Kent, Ohio.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Spitznagel
authors.affiliation: Weill Cornell Medical College, New York, New York.
authors.forename: Gladys
authors.initials: G
authors.lastname: Strain
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Michael
authors.initials: M
authors.lastname: Devlin
authors.affiliation: Neuropsychiatric Research Institute, Fargo, North Dakota; University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.affiliation: Neuropsychiatric Research Institute, Fargo, North Dakota; University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.affiliation: Kent State University, Kent, Ohio. Electronic address: jgunstad@kent.edu.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D009767:Obesity, Morbid / Q000150:complications* / Q000523:psychology / Q000601:surgery; D012372:ROC Curve; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Bariatric surgery; Cognitive function; Cognitive screening; Neuropsychological testing