MMSE-Based Dementia Prediction: Deep vs. Traditional Models

Early and accurate diagnosis of dementia is essential to improving patient outcomes and reducing societal burden. The Mini-Mental State Examination (MMSE) is widely used to assess cognitive function, yet traditional statistical and machine learning approaches often face limitations in capturing nonlinear interactions and subtle decline patterns. This study developed a novel deep learning-based dementia prediction model using MMSE data collected from domestic clinical settings and compared its performance with traditional machine learning models. A notable strength of this work lies in its use of item-level MMSE features combined with explainable AI (SHAP analysis), enabling both high predictive accuracy and clinical interpretability—an advancement over prior approaches that primarily relied on total scores or linear modeling. Data from 164 participants, classified into cognitively normal, mild cognitive impairment (MCI), and dementia groups, were analyzed. Individual MMSE items and total scores were used as input features, and the dataset was divided into training and validation sets (8:2 split). A fully connected neural network with regularization techniques was constructed and evaluated alongside Random Forest and support vector machine (SVM) classifiers. Model performance was assessed using accuracy, F1-score, confusion matrices, and receiver operating characteristic (ROC) curves. The deep learning model achieved the highest performance (accuracy 0.90, F1-score 0.90), surpassing Random Forest (0.86) and SVM (0.82). SHAP analysis identified Q11 (immediate memory), Q12 (calculation), and Q17 (drawing shapes) as the most influential variables, aligning with clinical diagnostic practices. These findings suggest that deep learning not only enhances predictive accuracy but also offers interpretable insights aligned with clinical reasoning, underscoring its potential utility as a reliable tool for early dementia diagnosis. However, the study is limited by the use of data from a single clinical site with a relatively small sample size, which may restrict generalizability. Future research should validate the model using larger, multi-institutional, and multimodal datasets to strengthen clinical applicability and robustness.