title: Is the Short Form of the Mini-Mental State Examination (MMSE) a better screening instrument for dementia in older primary care patients than the original MMSE? Results of the German study on ageing, cognition, and dementia in primary care patients (AgeCoDe).
abstract: The aim of the study was to investigate the psychometric properties of a Short Form of the Mini-Mental State Examination (SMMSE) for the screening of dementia in older primary care patients. Data were obtained from a large longitudinal cohort study of initially nondemented individuals recruited via primary care chart registries and followed at 18-month intervals. Item and scale parameters for MMSE and SMMSE scores were analyzed and cross-validated for 2 follow-up assessments (n1 = 2,657 and n2 = 2,274). Binary logistic regression and receiver-operating-characteristic (ROC) curve analyses were conducted in order to assess diagnostic accuracy parameters for MMSE and SMMSE scores. Cross-sectional differentiation between dementia-free and dementia patients yielded moderate to good results for MMSE and SMMSE scores. With regard to most diagnostic accuracy parameters, SMMSE scores did not outperform the MMSE scores. The current study provides first evidence regarding the psychometric properties of the SMMSE score in a sample of older primary care patients. However, our findings do not confirm previous findings that the SMMSE is a more accurate screening instrument for dementia than the original MMSE. Further studies are needed in order to assess and to develop short, reliable and valid instruments for routine cognitive screening in clinical practice and primary care settings.
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig.
authors.forename: Janine
authors.initials: J
authors.lastname: Stein
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig.
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.affiliation: Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf.
authors.forename: Hanna
authors.initials: H
authors.lastname: Kaduszkiewicz
authors.affiliation: Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf.
authors.forename: Marion
authors.initials: M
authors.lastname: Eisele
authors.affiliation: Central Institute of Mental Health, Medical Faculty, Mannheim/ Heidelberg University.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
authors.affiliation: Central Institute of Mental Health, Medical Faculty, Mannheim/ Heidelberg University.
authors.forename: Jochen
authors.initials: J
authors.lastname: Werle
authors.affiliation: Department of Psychiatry, Technical University of Munich.
authors.forename: Horst
authors.initials: H
authors.lastname: Bickel
authors.affiliation: Department of Psychiatry, Technical University of Munich.
authors.forename: Edelgard
authors.initials: E
authors.lastname: Mösch
authors.affiliation: Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School.
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.affiliation: Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School.
authors.forename: Jana
authors.initials: J
authors.lastname: Prokein
authors.affiliation: Institute of General Practice, Medical Faculty, University of Düsseldorf.
authors.forename: Michael
authors.initials: M
authors.lastname: Pentzek
authors.affiliation: Institute of General Practice, Medical Faculty, University of Düsseldorf.
authors.forename: Angela
authors.initials: A
authors.lastname: Fuchs
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, University of Hamburg.
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.affiliation: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, University of Hamburg.
authors.forename: Christian
authors.initials: C
authors.lastname: Brettschneider
authors.affiliation: Department of Psychiatry, University of Bonn.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Heser
authors.affiliation: Department of Psychiatry, University of Bonn.
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig.
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
authors.affiliation: Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf.
authors.forename: Martin
authors.initials: M
authors.lastname: Scherer
authors.affiliation: Department of Psychiatry, University of Bonn.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D000066492:Cognitive Aging / Q000523:psychology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D011320:Primary Health Care; D011594:Psychometrics; D012372:ROC Curve