Thursday, 3 April 2003

This presentation is part of : Detection of dementia in clinical and community settings

The Use of the MMSE as a Screening Tool for Dementia in the Community

Brian A Lawlor, St James Hospital, St James Hospital, Mercer's Institute for Research on Ageing, Dublin 8, Ireland

Objective: To determine the sensitivity, specificity and overall accuracy of the MMSE in screening for dementia in an elderly community dwelling population in Dublin.

Design: Cross-sectional community study.

Materials and Methods: 658 elderly individuals (mean age 74.8+7 years; 213 males, 445 females) were interviewed in their own homes using the MMSE (WORLD) and AGECAT, a computerized, diagnostic system for mental illness in the elderly. The diagnosis of dementia was made according to AGECAT case level organic which has been shown to have a high concordance rate (kappa 0.86-0.88) with the psychiatrist’s diagnosis of dementia.

Results: The optimum cut-off for this population was 22/23 which achieved a sensitivity of 80% and a specificity of 91.2% and an overall accuracy of 90.4% in the diagnosis of dementia. Both age and level of education were significantly associated with MMSE score.

Conclusion: The sensitivity and specificity of the MMSE for the diagnosis of dementia in Dublin is similar to other community based populations in other countries. The use of a lower cut-off can be explained on the basis of the lower level of education (mean years of education 10+1.8) of this inner city population.

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