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A survey was made of 2,792 subjects aged 65 and older living in the community of Gironde (South-Western France). The predictive value of the Mini-Mental state examination (MMS) as a screening instrument for the detection of cognitive impairment was tested against DSM-III criteria for dementing syndromes. Of the 2,792 subjects who consented to participate in the study, 101 met the DSM-III criteria for dementia, giving a 3.62% prevalence rate. With an MMS threshold of 24, the sensitivity was 100%, the specificity was 78%, and the positive predictive value was equal to 15%. Using the same MMS threshold, 572 subjects (85%) were false-positive for the diagnosis of dementia. A multiple logistic regression analysis revealed that age, sex, depressive symptomatology and educational level were independently correlated with false-positive cases of the MMS. Several issues are raised for using the MMS as the only screening instrument for cognitive impairment in elderly community residents.
Gagnon et al. (Tue,) studied this question.