Question: How effective, in comparison to other diagnostic tools highlighted by UK clinical guidelines, is the mini-mental state examination (MMSE), in the management of cognitive impairments in adults?

Answer:

There is some limited evidence, from one diagnostic case control study, that the seven minute screen is a useful screening tool for discriminating patients with dementia from cognitively intact patients and may have higher sensitivity than the Mini-mental State Examination (MMSE) for both Alzheimer's disease and other dementias. A poor quality systematic review suggested that the Six-Item Cognitive Impairment Test (6CIT) should be considered in specialist settings, but no numerical estimates of test performance were presented to support this statement. Evidence from two diagnostic cohort studies suggested that neither MMSE, nor the revised Addenbrooke's Cognitive Examination (ACE-R) had adequate performance to diagnose mild cognitive impairment (MCI) in patients with Parkinson's disease or acute stroke. The results of one further diagnostic cohort study indicated that the ACE-R, but not MMSE, had good sensitivity and specificity for MCI ≥ 1 year after transient ischemic attack (TIA) or stroke.

Further research is needed to provide evidence on the comparative performance of MMSE and the General Practitioner Assessment of Cognition (GPCOG) and the 6CIT, and to provide evidence on the performance of 7MS and ACE-R in a wider range of patient groups and at different degrees of cognitive impairment.

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