title: Beyond Screening: Can the Mini-Mental State Examination be Used as an Exclusion Tool in a Memory Clinic?
abstract: This study explores whether the Mini-Mental State Examination (MMSE) could reliably exclude definite dementia and dementia-free cases from requiring more extensive neuropsychological investigations in memory clinic settings in Singapore. Patients with memory complaints referred for possible dementia underwent the MMSE, followed by standardized neuropsychological and clinical assessments which led to a consensus diagnosis. MMSE cut-off points were derived stratified for education (less and equal/above primary level). Results show that after education stratification, using an optimal Positive Likelihood Ratio (PLR) and optimal Negative Likelihood Ratio (NLR), a higher percentage of patients were correctly identified as having dementia or dementia-free, with minimal misclassification rate. The finding suggests the MMSE can be used to exclude patients not requiring full neuropsychological assessments in a memory clinic.
authors: Memory, Aging and Cognition Center, Department of Pharmacology, National University Health System, Singapore 117600, Singapore. phcxx@nus.edu.sg.
authors: Xin
authors: X
authors: Xu
authors: Memory, Aging and Cognition Center, Department of Pharmacology, National University Health System, Singapore 117600, Singapore. eddie_chong@nuhs.edu.sg.
authors: Eddie
authors: E
authors: Chong
authors: Memory, Aging and Cognition Center, Department of Pharmacology, National University Health System, Singapore 117600, Singapore. phchs@nus.edu.sg.
authors: Saima
authors: S
authors: Hilal
authors: Memory, Aging and Cognition Center, Department of Pharmacology, National University Health System, Singapore 117600, Singapore. kamran.ikram@duke-nus.edu.sg.
authors: Mohammad Kamran
authors: MK
authors: Ikram
authors: Memory, Aging and Cognition Center, Department of Pharmacology, National University Health System, Singapore 117600, Singapore. drnvramani@gmail.com.
authors: Narayanaswamy
authors: N
authors: Venketasubramanian
authors: Memory, Aging and Cognition Center, Department of Pharmacology, National University Health System, Singapore 117600, Singapore. phccclh@nus.edu.sg.
authors: Christopher
authors: C
authors: Chen
keywords: Mini-Mental State Examination; cognitive assessment; dementia; memory clinic