Psychological Medicine

Research Article

Limits of the ‘Mini-Mental State’ as a screening test for dementia and delirium among hospital patients

James C. Anthonya1 c1, Linda LeReschea1, Unaiza Niaza1, Michael R. Von Korffa1 and Marshal F. Folsteina1

a1 Department of Mental Hygiene, Johns Hopkins School of Hygiene and Public Health, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

Abstract

With a psychiatrist's standardized clinical diagnosis as the criterion, the ‘Mini-Mental State’ Examination (MMSE) was 87% sensitive and 82% specific in detecting dementia and delirium among hospital patients on a general medical ward. The false positive ratio was 39% and the false negative ratio was 5 %. All false positives had less than 9 years of education; many were 60 years of age or older. Performance on specific MMSE items was related to education or age. These findings confirm the MMSE's value as a screen instrument for dementia and delirium when later, more intensive diagnostic enquiry is possible; they reinforce earlier suggestions that the MMSE alone cannot yield a diagnosis for these conditions.

Correspondence:

c1 Address for correspondence: Dr James C. Anthony, Department of Mental Hygiene, Johns Hopkins School of Hygiene and Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.

Metrics