The Mini Mental State Exam as a predictor of neuropsychological functioning after cardiac surgery.


Journal Article

OBJECTIVE: The present longitudinal study was designed to: 1) determine the ability of the Mini Mental State Exam (MMSE) to predict neuropsychologic impairment based on neuropsychologic testing five to seven days and six weeks after cardiac surgery; and 2) to determine whether the traditional or the education-related MMSE norms are more appropriate to use for this purpose. METHOD: The day before surgery (T1), before hospital discharge (T2), and six weeks after surgery (T3), 247 subjects completed a battery of five neuropsychologic tests. Subjects also completed the Center for Epidemiological Studies Depression Scale and the Speilberger State-Trait Anxiety Inventory. Subjects completed the MMSE two to three days after surgery. RESULTS: Stepwise regression analyses revealed that the MMSE significantly predicted only a small portion of the variance in neuropsychologic test performance at T2, and to an even lesser extent at T3, over and above the demographic variables. In assessing the association between an impairment score (derived from the neuropsychologic test battery) and the MMSE, we found that the traditional MMSE cut-off score maximized specificity (number of true negatives) while the education-adjusted MMSE cut-off scores maximized sensitivity (number of true positives). CONCLUSIONS: These results suggest that although the MMSE is widely used to assess cognitive mental status, it may have limited value in identifying patients with cognitive impairment post-cardiac surgery, and special attention must be paid to the cut-off scores used in interpreting the MMSE.

Full Text

Duke Authors

Cited Authors

  • Burker, EJ; Blumenthal, JA; Feldman, M; Thyrum, E; Mahanna, E; White, W; Smith, LR; Lewis, J; Croughwell, N; Schell, R

Published Date

  • 1995

Published In

Volume / Issue

  • 25 / 3

Start / End Page

  • 263 - 276

PubMed ID

  • 8567193

Pubmed Central ID

  • 8567193

International Standard Serial Number (ISSN)

  • 0091-2174

Digital Object Identifier (DOI)

  • 10.2190/VDMB-RJV7-M7UK-YYKG


  • eng

Conference Location

  • United States