Restrictions of the Mini-Mental State Examination - in acute stroke - study findings

Sep 27, 2026

Uploaded by Sarah

Restrictions of the Mini-Mental State Examination (MMSE) as a cognitive screening tool in acute stroke were assessed against a neuropsychological exam covering six cognitive domains. MMSE performance was administered to 34 stroke patients and 34 healthy controls within about two weeks post-stroke, with the mean interval of 6.5 ± 2.9 days. Classification accuracy was evaluated using receiver operating characteristic analysis, including AUC plus sensitivity and specificity across MMSE cut-off points.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

1. Introduction

2. Methods

2.1. Participants

2.1.1. Patients

Utrecht University Repository | Title | Restrictions of the Mini-Mental State Examination in acute stroke. | | --- | --- | | Authors | Nys , G. M.S; Van Zandvoort , M.J. E. ; de Kort , P. L. M. ; Jansen , BP; Kappelle , L.J. ; De Haan , E. H. F. | | Published in | Archives of Clinical Neuropsychology | | Publication Date | 2005 | | Link | [https://dspace.library. uu. nl/handle/1874/1](https://dspace.library. uu. nl/handle/1874/1)1151 | | Citation | Nys , G M S , Van Zandvoort , M J E , de Kort , P L M , Jansen , BP, Kappelle , L J & De Haan , E H F 2005 , ' Restrictions of the Mini-Mental State Examination in acute stroke. ' , Archives of Clinical Neuropsychology, vol. 20 , no. 5 , pp. 623-629. | | Rights | [https://www. uu. nl/en/university-library/license-and-reuse-conditions](https://www. uu. nl/en/university-library/license-and-reuse-conditions) | Archives of Clinical Neuropsychology 20 (2005) 623–629 Restrictions of the Mini-Mental State Examination in acute stroke G.M. S. Nys a,b,∗ , M.J.E. van Zandvoort a,b , P.L.M. de Kort c,d, B.P.W. Jansend, L.J. Kappelleb , E.H.F. de Haan a,b a Psychological Laboratory, Helmholtz Institute, Utrecht University, Heidelberglaan 2, 3584 CS Utrecht, The Netherlands b Department of Neurology, University Medical Center Utrecht, The Netherlands c Department of Neurology, St. Elisabeth Hospital Tilburg, The Netherlands d Department of Neurology, Tweesteden Hospital Tilburg, The Netherlands Accepted 9 April 2005 Abstract While the Mini-Mental State Examination (MMSE) was originally developed to screen for dementia and delirium, many neurologists use this measure as a screening instrument for ‘cognitive impairment’in hospitalized stroke patients. However, the validity of the MMSE as such has never been evaluated in acute stroke. We administered the MMSE in addition to a neuropsychological examination covering six cognitive domains to 34 stroke patients (mean interval between stroke and examination, 6.5 ± 2.9 days) and 34 healthy controls. The area under the receiver operating characteristic curve (AUC) was calculated in addition to the sensitivity and speciﬁcity for various cut-off points on the MMSE. Seventy percent of the patients were impaired in at least one cognitive domain. The accuracy of the MMSE in detecting cognitive impairment was no better than chance (AUC = 0.67; p = 0.13) . No optimum MMSE cut-off value could be identiﬁed. The MMSE is particularly insensitive to impairmentsin abstract reasoning, executive functioning, and visual perception/construction. © 2005 National Academy of Neuropsychology. Published by Elsevier Ltd. All rights reserved. Keywords: Mini-Mental State Examination (MMSE); Stroke; Construct validity; Neuropsychological assessment ∗ Corresponding author. Tel.: +31 30 2533405; fax: +31 30 2534511 . E-mail address: [g.nys@fss.uu.nl](g.nys@fss.uu.nl) (G.M.S. Nys). 0887-6177/$ – see front matter © 2005 National Academy of Neuropsychology. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.acn.2005.04.001 624 G.M.S. Nys et al. / Archives of Clinical Neuropsychology 20 (2005) 623 –629 1. Introduction Cognitive disorders in the acute stage of stroke are common and are important independent predictors of adverse outcome in the long term (Nys et al., 2005) . Therefore, a whole range of brief cognitive measures has been used to screen for cognitive impairment inpatients with acute stroke. The Mini-Mental State Examination (MMSE) (Folstein, Folstein, & McHugh, 1975)is currently the mainstay of screening instruments. This instrument was originally developed to screen for dementia and delirium in a psychiatric setting, and has been shown to have a good sensitivity and speciﬁcity as such (Folstein et al., 1975) . Subsequently, the use of the MMSE has been extended and many studies now use it as a screening instrument for ‘global cognitive impairment’(e.g. Narushima, Chan, Kosier, & Robinson, 2003; Patel et al., 2003) . How

FAQs

What was the study designed to test about the MMSE in acute stroke?

To evaluate the construct validity of the MMSE as a screening instrument for cognitive impairment in patients with acute stroke.

How were participants assessed in the study?

The MMSE was administered along with a neuropsychological examination covering six cognitive domains to 34 stroke patients and 34 healthy controls within about two weeks post-stroke.

Did the MMSE show good accuracy for detecting cognitive impairment in acute stroke?

No. The MMSE accuracy was no better than chance (AUC = 0.67; p = 0.13), and no optimum MMSE cut-off value was identified.

Sep 27, 2026

Uploaded by Sarah