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David F. Tang-Wai, MDCM; David S. Knopman, MD; Yonas E. Geda, MD; Steven D. Edland, PhD; Glenn E. Smith, PhD; Robert J. Ivnik, PhD; Eric G. Tangalos, MD; Bradley F. Boeve, MD; Ronald C. Petersen, PhD, MD

Arch Neurol. 2003;60:1777-1781.

Background  The Mini-Mental State Examination (MMSE) is the most widely used brief screening measure of cognition, but it is not sensitive in detecting mild memory or other cognitive impairments. The Short Test of Mental Status (STMS) was specifically developed for use in dementia assessment and was intended to be more sensitive to problems of learning and mental agility that may be seen in mild cognitive impairment (MCI).

Objective  To compare the STMS and MMSE for detecting or predicting MCI.

Design  Comparison of STMS and MMSE scores at baseline among 4 groups of patients: 788 patients with stable normal cognition, 75 patients with normal cognition at baseline but who developed incident MCI or Alzheimer disease during follow-up, 129 patients with prevalent MCI at baseline, and 235 patients with prevalent mild Alzheimer disease. All patients and control subjects for this study were evaluated through the Mayo Alzheimer's Disease Patient Registry or the Mayo Clinic Alzheimer's Disease Research Center, Rochester, Minn, using a standardized diagnostic approach.

Results  The STMS was slightly more sensitive than the MMSE in discriminating between patients with stable normal cognition and patients with prevalent MCI. The STMS was superior to the MMSE in detecting deficits in cognition in individuals who had normal cognition at baseline but later developed incident MCI or Alzheimer disease.

Conclusions  Compared with the MMSE, the STMS was better able to document MCI and was more sensitive in detecting deficits in cognition in individuals who had normal cognition at baseline but later developed incident MCI or Alzheimer disease.

From the Departments of Neurology (Drs Tang-Wai, Knopman, Boeve, and Petersen), Psychiatry (Dr Geda), Health Sciences Research (Dr Edland), Psychology (Drs Smith and Ivnik), and Internal Medicine (Dr Tangalos) and the Mayo Alzheimer's Disease Research Center (Drs Tang-Wai, Knopman, Geda, Edland, Smith, Ivnik, Tangalos, Boeve, and Petersen), Mayo Clinic, Rochester, Minn.

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