The limited utility of the Mini-Mental State Examination in screening people over the age of 75 years for dementia in primary care

Abstract

The Mini-Mental State Examination (MMSE) is used worldwide to assess cognitive status and it has been recommended for use in primary care to detect dementia. In this study, the MMSE was administered during annual health checks for patients over 75 years of age in nine practices by a member of the primary care team. The mean age was 80 years. Of the 709 patients screened, 286 scored at or below the cut-off point, which was set at 26/30 on the MMSE, and they were invited to be assessed further by a researcher, using the well-validated GMS-AGECAT diagnostic system. Eighty-four of these patients refused, 173 were identified as not having dementia, and 29 (14%) were identified as having dementia. These results, with an 86% false-positive rate, raise concerns regarding the utility of the MMSE as a screening instrument for dementia in primary care.