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Am J Psychiatry 1991; 148:102-105
Copyright © 1991 by American Psychiatric Association
Reliability of a Standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination
DW Molloy, E Alemayehu and R Roberts
Department of Medicine, McMaster University, Hamilton, Ont., Canada.
OBJECTIVE: The objective of this study was to compare the reliability of
the Mini-Mental State Examination with that of a new Standardized
Mini-Mental State Examination, which has expanded guidelines for
administration and scoring. METHOD: The subjects were 32 stable elderly
residents of a nursing home and 16 elderly residents of a chronic care
hospital unit. Six raters administered the Folstein Mini-Mental State to 22
of these stable elderly subjects, and five raters administered the
standardized version to 26 of these subjects. Each subject was tested on
three different occasions 1 week apart. Each rater tested 4-6 subjects at
the first and third weeks and 4-6 different subjects at the second week.
The analytic technique used was one-way analysis of variance to estimate
the interrater variance and the intrarater variance. RESULTS: The
intrarater variance on all occasions was reduced by 86% and the interrater
variance was reduced by 76% when the Standardized Mini-Mental State was
used; the reductions in variance were significant (p less than 0.003). The
intraclass correlation for the Mini-Mental State was 0.69; for the
standardized version it was 0.90. It took less time to administer the
Standardized Mini-Mental State than the Mini-Mental State. CONCLUSIONS: The
Standardized Mini- Mental State had better reliability than the Mini-Mental
State in this study group. Although the improved reliability of the
Standardized Mini- Mental State was achieved by reducing measurement noise,
this advantage would likely occur in a broad spectrum of patients.
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