title: Performance of the Modified Mini-Mental State Examination (3MS) in Assessing Specific Cognitive Function in Patients Undergoing Peritoneal Dialysis.
abstract: OBJECTIVE
  While Cognitive impairment (CI) has been identified as an independent risk factors for mortality in patients undergoing peritoneal dialysis (PD), it is inadequately assessed. We evaluated the applicability of the Modified Mini-Mental State Examination (3MS) in assessing specific cognitive function and compared it to a detailed neuropsychological test battery as the reference standard.
  
  
  METHODS
  In this multicentric cross-sectional study, we enrolled 445 clinically stable patients from five PD units, who were undergoing PD for at least 3 months. The 3MS was evaluated for general cognitive function. A detailed neuropsychological battery including domains of immediate memory, delayed memory, executive function, language, and visuospatial ability were evaluated as reference standards. Sensitivity and specificity of the 3MS was determined by using receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  The CI prevalence evaluated by 3MS was 23.6%. PD patients with CI performed worse in all cognitive domains. The 3MS correlated well with specific cognitive domains. However, 18.5%, 57.4%, 12.6%, 8.8%, and 41.2% of patients whom were idendified as normal by 3MS still showed executive dysfunction, immediate memory impairment, delayed memory impairment, and language-ability and visuospatial-ability impairment, respectively. The 3MS identified patients having specific cognitive dysfunction with varied extent of diagnostic value, with 0.50, 0.42, 0.35, 0.34, and 0.26 of Youden index in executive function, delayed memory, language ability, immediate memory, and visuospatial ability, respectively.
  
  
  CONCLUSIONS
  The 3MS is not a comprehensive instrument for major cognitive domains in PD patients. It could, however, be used for executive dysfunction and delayed memory impairment screening.
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital; Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital; Beijing, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Tian
authors.affiliation: Renal Division, Peking University Shenzhen Hospital, Shenzhen, China.
authors.forename: Zu-Ying
authors.initials: ZY
authors.lastname: Xiong
authors.affiliation: Renal Division, Peking University Shenzhen Hospital, Shenzhen, China.
authors.forename: Jin-Lan
authors.initials: JL
authors.lastname: Liao
authors.affiliation: Renal Division, the Second Hospital of Anhui Medical University, Anhui, China.
authors.forename: Li
authors.initials: L
authors.lastname: Hao
authors.affiliation: Renal Division, the Second Hospital of Anhui Medical University, Anhui, China.
authors.forename: Gui-Ling
authors.initials: GL
authors.lastname: Liu
authors.affiliation: Renal Division, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China.
authors.forename: Ye-Ping
authors.initials: YP
authors.lastname: Ren
authors.affiliation: Renal Division, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Renal Division, Handan Central Hospital, Hebei, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Duan
authors.affiliation: Renal Division, Handan Central Hospital, Hebei, China.
authors.forename: Zhao-Xia
authors.initials: ZX
authors.lastname: Zheng
authors.affiliation: Peking University Sixth Hospital; Peking University Institute of Mental Health; Key Laboratory of Mental Health, Ministry of Health, Beijing, China.
authors.forename: Wen-Xiang
authors.initials: WX
authors.lastname: Quan
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital; Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Dong
mesh_terms: D000328:Adult; D000368:Aged; D000377:Agnosia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D007806:Language Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors