Mini-Mental State Examination (MMSE) for Early Detection of Dementia in People with Mild Cognitive Impairment (MCI)
Arevalo-Rodriguez I, Smailagic N, Roqué-FigulsM, Ciapponi A, Sanchez-Perez E, Giannakou A, Pedraza OL, Bonfill Cosp X, Cullum S. Mild cognitive impairment (MCI) with A systematic review Cochrane Database 2021, No. 7. Art. No.: CD010783. doi: 10.1002 /14651858.CD010783.pub3. Accessed July 27, 2021.
Commentary
This study will investigate the accuracy of a mini-mental state test for the early detection of people with mild cognitive impairment.
Eleven heterogeneous studies involving a total of 1569 MCI patients who were followed for conversion to dementia were selected for this review.
Four studies assessed the role of the baseline score of the MMSE in the conversion from MCI to all-cause dementia, and eight studies evaluated this test in the conversion from MCI to Alzheimer's disease dementia.
In addition,
only one study provided information on the MMSE and conversion from MCI to vascular dementia, and found that the accuracy of the baseline MMSE score was 23-76% sensitivity and 40-94% specificity for general conversion from MCI to dementia.
For conversion from MCI to Alzheimer's disease dementia, the accuracy of baseline MMSE scores ranged from 27 to 89% sensitivity and 32 to 90% specificity.
And only one study on conversion from MCI to vascular dementia was found, with a sensitivity of 36% and specificity of 80%, indicating an incidence of vascular dementia of 6.2%.
The reviewers commented
that they could find no evidence to support a substantial role for MMSE as a stand-alone, single-dose study in identifying MCI patients at risk for dementia.
Thus, it seems conceivable that clinicians may prefer to require additional extensive testing for the management of these patients. An important aspect that these themes will evaluate in future updates is whether the conversion from MCI stage to dementia can be better predicted by changes in the MMSE over time rather than by a single measurement.
It will also be important to assess whether a series of tests, rather than isolated tests, will be more successful in predicting the conversion from MCI to dementia.
