Standardized mini-mental state examination - Use and interpretation

OBJECTIVE To review administration of the Standardized Mini-Mental State Ex amination (SMMSE) for dementia and depression and to evaluate how well it i nterprets older people's cognitive function. QUALITY OF EVIDENCE literature from January 1990 to December 1999 was searc hed via MEDLINE using the MeSH headings Alzheimer Disease, Vascular Dementi a, Lewy Bodies, and Depression. Several studies have described the reliabil ity and validity of the SMMSE. MAIN MESSAGE The SMMSE, a standardized approach to scoring and interpreting older people's cognitive function, provides a global score of cognitive ab ility that correlates with daily function. Careful interpretation of result s of the SMMSE, together with history and physical assessment, can assist i n differential diagnosis of cognitive impairment resulting from Alzheimer's disease, vascular dementia, dementia with Lewy bodies, or depression. Repe ated measurements can be used to assess change over time and response to tr eatment. CONCLUSION The SMMSE is a valuable tool for family doctors who are often th e first medical professionals to identify changes in patients' cognitive fu nction. The SMMSE requires little time to complete and is a key component o f a comprehensive dementia workup. Determining whether a patient has dement ia is important because there are now effective medications that are most b eneficial if started early.