Variability in annual Mini-Mental State Examination score in patients with probable Alzheimer disease: a clinical perspective of data from the Consortium to Establish a Registry for Alzheimer's Disease.


Journal Article

OBJECTIVE: To determine the variability in annual Mini-Mental State Examination scores of patients with Alzheimer disease enrolled in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD). PATIENTS: A total of 372 patients with probable Alzheimer disease with 1 or more years of follow-up. SETTING: Twenty-one CERAD clinical sites throughout the United States. RESULTS: An average annual decline of 3.4 points in CERAD patients returning for longitudinal reassessments was close to the SD of the measurement error of 2.8 points for the Mini-Mental State Examination. There was wide variability in individual rates of decline. Even with 4 years of follow-up, 15.8% of the patients had no clinically meaningful decline in Mini-Mental State Examination score (defined as a change in initial score >3, ie, 1 SD of measurement error). Validity of measurements of the rate of change in Mini-Mental State Examination scores improved with longer observation intervals and was reliable for most patients when observations were separated by 3 or more years. CONCLUSIONS: Although the Mini-Mental State Examination is a useful screening instrument to assess level of cognitive function, it has limited value in measuring the progression of Alzheimer disease in individual patients for periods less than 3 years because of a large measurement error and substantial variation in change in annual score.

Full Text

Duke Authors

Cited Authors

  • Clark, CM; Sheppard, L; Fillenbaum, GG; Galasko, D; Morris, JC; Koss, E; Mohs, R; Heyman, A

Published Date

  • July 1999

Published In

Volume / Issue

  • 56 / 7

Start / End Page

  • 857 - 862

PubMed ID

  • 10404988

Pubmed Central ID

  • 10404988

International Standard Serial Number (ISSN)

  • 0003-9942

Digital Object Identifier (DOI)

  • 10.1001/archneur.56.7.857


  • eng

Conference Location

  • United States