MMSE-2 Flashcards
overview
-Original MMSE is one of the most widely used brief screening instruments for cognitive impairment
-used in a variety of settings, including screening individual patients, tracking progress over time, screening for large populations, and clinical trials
-mostly just know the differences in the change
goals for the revision
-1. Revise some of the original items to better standardize its administrations, particularly for translations
-ex. no if ands or buts doesnt translate
-2. Provide an even briefer version that could be used for rapid assessment
-3. Provide a slightly longer version that would be more sensitive to subcortical dementia and that would not have a ceiling effect - after a certain point not as sensitive to pick up certain changes
-4. Develop equivalent alternate forms to decrease practice effects in serial administration
Goal 1: revise original items
-The MMSE-2 Standard Version (MMSE-2:SV) maintains the same structure and scoring as the original MMSE
-Changes were made to improve problematic items and to better standardize administration in other languages (e.g., penny, no if, ands, or buts)
MMSE-2: standard version- comparing the original to new
-no motor component of the comprehension portion now
-reading, writing, drawing- same
equivalency between the MMSE and MMSE-2: SV
-Like the MMSE, the MMSE-2:SV has a raw score range of 0-30
-The generalizability coefficient (n = 411) between the MMSE and the MMSE-2:SV total raw score was .97
-Therefore, it is possible to switch from MMSE to the MMSE-2:SV without compromising longitudinal data and without any change in the normal range of scores
Goal 2: develop briefer version
-Can be used for quick cognitive screener, specifically when an individual has not been referred for specific cognitive impairment
-Composed of Registration/Recall, Orientation to Time, and Orientation to Place
-Raw score ranges from 0-16 points
-Tasks were selected based on literature review, use in the MMSE, and their sensitivity and specificity to detect dementia
goal 3: develop expanded version
-Consists of all of the items on the MMSE-2:SV plus two new tasks:
-Story Memory: An immediate recall of a brief story
-Processing Speed: A symbol-digit coding task
Theory behind the decision:
Wanted an additional memory task due their importance in this area.
Added subtests that statistically differentiate mild dementia from normals
Wanted to make it more difficult to fake
MMSE-2: expanded version
-Improves the clinical utility of the MMSE by:
-Extending the test’s ceiling- increase sensitivity
-Increasing the range of raw scores (0-90)
-Increasing the sensitivity for individuals with less severe cognitive impairment (subcortical dementia, MCI)
goal 4: develop equivalent alternate forms
-Two forms (Blue and Red) were developed for each of the 3 versions of the MMSE-2
-Based on the results of the equating study, the accuracy of the equating process was confirmed
administration issues
-18 years and older
-Relatively easy to administer, typically one training session is sufficient
-Test Materials:
-User’s Manual
-Pocket Norms Guide
-Scoring Templates for Processing Speed
-Administration Forms :
-MMSE-2:BV Blue and Red Form
-MMSE-2:SV Blue and Red Form
-MMSE-2:EV Blue and Red Form
determining which version is appropriate
-MMSE-2:BV
-Adequate for screening large populations; screening individuals in practice who have not been referred because of cognitive complaints
-MMSE-2:SV
-Used first if referred because of complaint of cognitive decline or if patient indicates memory is not as good as it use to be; depending on results may want to supplement with MMSE-2:EV
-MMSE-2:EV
-Same as above + well educated (ceiling effect); suspected subcortical dementia
scoring
-Mean raw total scores are presented by age and education level
-T scores are also presented by age and education level
-Pocket Guide
-Reliable Change Scores
-Although T scores are provided, it is the raw scores that are usually interpreted
interpretation
-A cut score of 22/23 is typically used with the original MMSE
-Because the MMSE-2:SV is equivalent to the MMSE, the same cut score is suggested
-The authors have not provided specific recommendations for the new forms, however ranges of raw score cut scores are provided for the dementia, AD, and subcortical samples by form
-22/23 is cutoff for Standard Version. If below this raw score, likely cognitive impairment.
development of the norms
-Because of the importance of age and education on MMSE-2 scores norms were developed for several different age and education ranges
-Two resources for age and education adjustments are provided:
-1. Means and standard deviations of total raw scores by age and education groups
-2. Age- and education-adjusted T scores (continuous norming method)
