The Mini-Mental State Examination (MMSE), a brief test to assess cognitive status, is heavily influenced by age and education. Data from this study will ameliorate the overall reliability of MMSE as a screening test for cognitive impairment in elderly people. All participants were. PDF | Provides a set of normative data on the Mini-Mental State Examination ( MMSE) Ss were selected in 6 Italian cities and in the Republic of San Marino. ± Standard Deviation of MMSE Total Score by Age Decade and Educational Level. Commentary on clinical use of the MMSE and bibliography of research using the MMSE in languages Full list, download pdf, kb, Italian, download pdf, 5kb.
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Item Differences in Spanish Versions of the MMSE. .. Performance Ostrosky- Solı´s, F., Lo´ pez-Arango, G., & Ardila, A. of the Italian version of the Mini-Mental . The only mandatory test suggested from the Italian Ministry of Health in was the mini Global cognitive abilities were assessed using the MMSE; the score was .. , phunctibalmyimie.ga 6. The Mini-Mental State Examination (MMSE) was first published in by M. F. PDF icon Standardised Mini-Mental State Examination (SMMSE) Guide.
Diagnosis is well accepted by patients with a survey of patients in a memory clinic showing that even patients with severe dementia would prefer to be told their diagnosis [ 15 ]. Although diagnosis has benefits it should also be appreciated that it can have major psychosocial effects, both positive and negative [ 16 ]. Dementia and cognitive impairment are common among older hospital patients and remain under diagnosed [ 17 , 18 ], in common with other mental health problems in the same group [ 19 ].
In Sampson et al. The diagnosis of dementia in general hospitals is also complicated by the complex diagnostic challenge of concurrent delirium, with up to two-thirds of people with delirium having concurrent dementia, and dementia itself being a significant risk factor for the development of delirium .
The need to improve diagnosis of dementia in hospitals is long established .
Medical admission could therefore offer a timely opportunity to identify potential cases of dementia. Recognition of dementia also allows for improved care during the hospital admission. Improved care may include avoiding new medical events known to be more likely among inpatients with dementia [ 22 ], accessing dementia services, planning legal and capacity assessments and involving family in care decisions [ 23 ].
There are many screening instruments in current use and guidelines exist on which tests to use.
These are often not restricted to hospital use and may not be validated for hospital use. A Further tool in common use is the Addenbrooke's Cognitive Assessment .
All these professional guidelines emphasise a two-stage approach; that is, detailed assessment after initial screening or clinical suspicion. The aim of this review is to determine which of the instruments advocated for screening for dementia have been validated in older hospital inpatients and therefore inform decision-making for services. Search strategy and selection criteria An electronic database search of Embase, PsycINFO and MEDLINE was made for articles in English using search terms in the following three domains: dementia and cognitive impairment, diagnosis and screening tests, and thirdly general hospital inpatients.
Supplementary data available in Age and Ageing online, Appendix 1 contain the full search strategy. Only English language articles were accessed due to lack of resources to translate.
The abstracts were then screened by two assessors T.
Patients studied in psychiatric wards, memory clinics and the community were excluded Included an age defined group of older people 60 years or older Published review articles on cognitive screening were also examined to identify any further studies [36—43]. An additional electronic search was done with each identified instrument as a key search term with the search terms for general hospital inpatients to identify any further validation studies.
The reference sections of the selected papers were also studied as were relevant clinical guidelines. The full texts of the selected studies were reviewed independently by three reviewers T.
Studies include older people 60 years or older as the main subject group or a clearly defined subgroup. At least 10 cases of dementia according to gold standard. From the selected papers, the following data were recorded: patient group and sample size, mean age and proportion female, prevalence of dementia, test used and cut-off, comparator gold standard , sensitivity and specificity.
Any disagreements were decided by consensus. Following previous convention, statistical analysis was done to produce a meta-analysis if there were three studies assessing the same test . We used Meta-Disc version 1. The diagnostic odds ratio is also a measurement of diagnostic accuracy independent of prevalence and represents the probability of the test being positive if a person has the disease relative to the odds of the test being positive if the person does not have the disease.
Heterogeneity was measured by calculating I2. Results The initial search returned articles of which 18 were selected. Three further articles were identified by the review articles selected and a further three identified by searching by specific tests.
The hazard of the study recruitment meant that only 3 patients fitted this description, including two with very severe impairments.
At the origin of our study, there were some items that drew our attention: memory and orientation items, not testable with the MMSE and MoCA in case of aphasia. In daily practice, teams are regularly confronted with the presence of these impairments in aphasic patients. It is in fact an important issue for physicians and essential for families in preparing the patient for being discharged home. We assumed that it would be possible to evaluate memory and orientation with the CASP in a large proportion of aphasic patients.
This was the case in our study, especially in case of severe impairments predominant in the verbal expression.
In reality, it is sometimes difficult for aphasic patients to differentiate test failure and failing to understand the instructions. In fact, it is quite certain that purely visual items, adapted to language disorders, were problematic in case of neurological visual impairments NVI.
This in fact brings up the more general issue of the neuropsychological evaluation: just like aphasia interferes with verbal tests, NVI interfere with tests memory or others involving visual aids.
In this study, the three scores were highly correlated between themselves. In our study, we were expecting and even hoping for a poor concordance between the CASP and the other two tests. This, in fact, was clearly the case in our study.
Furthermore, for any patient aphasic or not , the structure difference between the three batteries does indeed induce a poor concordance between the scores. Another element, gestural praxis assessment is only available in the CASP. It is thus natural for the concordance between their score to be poor. This suggests that the severity of language impairments negatively influenced the MMSE and MoCA scores, well beyond what could be explained by aphasia alone or associated cognitive impairments.
Finally, the fact that the mean administration times for the MMSE and MoCA were slightly weaker in patients with severe language impairments suggests also that these impairments might have influenced the administration of these tests.
This was not the case for the CASP. In daily clinical practice, just like in the framework of clinical research, evaluating cognitive disorders such as memory or orientation impairments remains difficult in aphasic patients and restricted to experimented physicians, speech and language therapists or neuropsychologists.