This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Stability, Validity, and Screening Utility

Janet Grace, PhD; Jodi D. Nadler, PhD; Desiree A. White, PhD; Thomas J. Guilmette, PhD; Anthony J. Giuliano, PhD; Andreas U. Monsch, PhD; Matthew G. Snow, PhD

Arch Neurol. 1995;52(5):477-484.

Abstract
Objective
Two studies were conducted with the Folstein Mini-Mental State Examination (MMS) and the Modified Mini-Mental State Examination (3MS) to examine whether the expanded version is a more useful screening tool in stroke populations.

Design
Clinical utility of screening tests (MMS and 3MS) was evaluated in reference to neuropsychological performance and functional outcome in rehabilitation. Setting: Medical rehabilitation unit of universityaffiliated hospital.

Patients
Two groups (n=77, and n=70) of patients who were admitted consecutively.

Main Outcome Measures
Neuropsychological performance and functional outcome (functional independence measure).

Results
The reliability, stability, and validity of the 3MS were established in the stroke population. Classification accuracy did not differ between the MMS and 3MS, although the 3MS had higher sensitivity. In detecting cognitive impairment when compared with the extended neuropsychological battery, both instruments were adequate in patients with left-sided cerebrovascular accidents and were ineffective in patients with right-sided cerebrovascular accidents. The 3MS correlated with some cognitive domains missed by the MMS, thus adding useful clinical information. Finally, the 3MS was a significantly better predictor of functional outcome than the MMS.

Conclusions
The 3MS was found to be a reliable, valid, and stable cognitive screening instrument in the stroke population. Classification accuracy indicates that both screening instruments are not strong in their ability to detect cognitive impairment in patients with stroke, especially in right-sided cerebrovascular accidents. The 3MS does have some advantages over the MMS; the expanded version of the screen not only provides additional cognitive information but also allows for better predicting of functional outcome.

Author Affiliations
From Brown University School of Medicine, Providence, RI (Drs Grace, Nadler, White, and Guilmette); Cornell University Medical Center, New York, NY (Dr Nadler); University of California—San Diego (Drs White and Monsch); University of Virginia Medical School, Charlottesville (Dr Giuliano); and University of Connecticut Health Sciences Center, Farmington (Dr Snow).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Estimating the Minimal Clinically Important Difference of the Stroke Rehabilitation Assessment of Movement Measure
Hsieh et al.
Neurorehabil Neural Repair 2008;22:723-727.
ABSTRACT  

Double-Blind Randomized Treatment of Poststroke Depression Using Nefiracetam
Robinson et al.
J. Neuropsychiatry Clin. Neurosi. 2008;20:178-184.
ABSTRACT | FULL TEXT  

Effect of Carotid Artery Stenting on Cognitive Function in Patients With Carotid Artery Stenosis: Preliminary Results
Turk et al.
Am. J. Neuroradiol. 2008;29:265-268.
ABSTRACT | FULL TEXT  

A Preliminary Study of the Mini-Mental State Examination in a Spanish Child Population
Rubial-Alvarez et al.
J Child Neurol 2007;22:1269-1273.
ABSTRACT  

Benchmarks for designing two-stage studies using modified mini-mental state examinations: experience from the Women's Health Initiative Memory Study
Espeland et al.
Clin Trials 2006;3:99-106.
ABSTRACT  

Effects of Problem-Oriented Willed-Movement Therapy on Motor Abilities for People With Poststroke Cognitive Deficits
Tang et al.
ptjournal 2005;85:1020-1033.
ABSTRACT | FULL TEXT  

Cognitive Impairment and Decline Are Associated with Carotid Artery Disease in Patients without Clinically Evident Cerebrovascular Disease
Johnston et al.
ANN INTERN MED 2004;140:237-247.
ABSTRACT | FULL TEXT  

Detection of grey matter loss in mild Alzheimer's disease with voxel based morphometry
Frisoni et al.
J. Neurol. Neurosurg. Psychiatry 2002;73:657-664.
ABSTRACT | FULL TEXT  

A Double-Blind, Placebo-Controlled, Randomized Clinical Trial of Transdermal Dihydrotestosterone Gel on Muscular Strength, Mobility, and Quality of Life in Older Men with Partial Androgen Deficiency
Ly et al.
J. Clin. Endocrinol. Metab. 2001;86:4078-4088.
ABSTRACT | FULL TEXT  

Randomised, clinically controlled trial of intensive geriatric rehabilitation in patients with hip fracture: subgroup analysis of patients with dementia
Huusko et al.
BMJ 2000;321:1107-1111.
ABSTRACT | FULL TEXT  

A Short Screening Instrument for Poststroke Dementia : The R-CAMCOG
de Koning et al.
Stroke 2000;31:1502-1508.
ABSTRACT | FULL TEXT  

Outcome Measures in Acute Stroke Trials : A Systematic Review and Some Recommendations to Improve Practice
Duncan et al.
Stroke 2000;31:1429-1438.
ABSTRACT | FULL TEXT  

The CAMCOG: A Useful Screening Instrument for Dementia in Stroke Patients
de Koning et al.
Stroke 1998;29:2080-2086.
ABSTRACT | FULL TEXT  

Presence and Treatment of Vascular Risk Factors in Patients With Vascular Cognitive Impairment
Rockwood et al.
Arch Neurol 1997;54:33-39.
ABSTRACT