Mild dementia or cognitive impairment: The Modified Mini-Mental State Examination (3MS) as a screen for dementia

Objective: To examine the Modified Mini-Mental State Examination (3MS) as a screen for dementia. Method: A group of 1092 elderly Edmonton community residents completed the 3MS and the Geriatric Mental State Examination (GMS). 3MS sensitivity and s pecficity were determined by comparing positive 3MS screens (score less tha n or equal to 77) with those classified as GMS "organic" (severity level 3, equivalent to a clinical diagnosis). In the Canadian Study of Health and A ging (CSHA), 2914 subjects received the 3MS and a clinical examination. A g roup described as having cognitive impairment but no dementia (CIND)" was i dentified. Results: In Edmonton, the 3MS showed 88% sensitivity, 90% specificity, 29% positive predictive value (PPV), and 99% negative predictive value (NPV). I n the CSHA, 30% of subjects receiving both the 3MS and a clinical examinati on were classified as CIND. One-half of these were classified as having "ag e associated memory impairment (AAMI)" or as "unspecified." Conclusions. The 3MS with a cutting score of 77/78 proved a reasonable scre ening instrument; 1 case in 3 screening "positive" has dementia, butfew (0. 64%) will be missed by screening "negative. " CIND, account ngfor 2 out of 3 cases screened positive by the 3MS in the Edmonton study, is a substanti al, heterogeneous group that is not necessarily "predementia" but that in m any cases merits further investigation.