The Validity and Reliability of the Mini-Mental State Examination-2 for Detecting Vascular Mild Cognitive Impairment and Vascular Dementia in a Korean Population.

Abstract

Background: This study aimed to evaluate the validity and reliability of the Mini-Mental State Examination, 2nd Edition (MMSE-2), as a cognitive screening tool for patients with vascular mild cognitive impairment (VaMCI) and vascular dementia (VD) in a Korean population. Specifically, we investigated whether the MMSE-2 effectively detects early cognitive changes associated with vascular cognitive impairment (VCI) that might be overlooked by the original Mini-Mental State Examination (MMSE).

Methods: A total of 66 patients with VaMCI, 46 patients with VD, and 75 cognitively healthy older adults participated in this study. All participants provided informed consent and underwent assessments using the MMSE-2, the original MMSE, and a comprehensive neuropsychological test battery.

Results: The MMSE-2 demonstrated robust performance in differentiating participants across Clinical Dementia Rating (CDR) stages and CDR-Sum of Boxes scores. It exhibited excellent internal consistency, high test-retest reliability, and strong interrater reliability. Concurrent validity with the original MMSE and other neuropsychological measures was also high. The MMSE-2 showed relatively high sensitivity and specificity in distinguishing normal cognitive aging, VaMCI, and VD.

Conclusion: The MMSE-2 is a valid and reliable tool for assessing cognitive impairment in patients with VCI in a Korean population. While its specificity in differentiating VaMCI from healthy aging remains relatively modest, the MMSE-2 demonstrates superior sensitivity in detecting VaMCI compared to the original MMSE. These findings suggest that the MMSE-2 is a valuable screening instrument for identifying early cognitive changes associated with VCI.