Reliability of a Standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination

Objective: The objective of this study was to compare the reliability of the Mini-Mental State Examination with that of a new Standardized Mini-Mental State Examination, which has expanded guidelines for administration and scoring. Method: The subjects were 32 stable elderly residents of a nursing home and 1 6 elderly residents of a chronic care hospital unit. Six raters administered the Folstein Mini-Mental State to 22 of these stable elderly subjects, and five raters administered the standardized version to 26 of these subjects. Each subject was tested on three different occasions 1 week apart. Each rater tested 4-6 subjects at the first and third weeks and 4-6 different subjects at the second week. The analytic technique used was one-way analysis of variance to estimate the interrater variance and the intrarater variance. Results: The intrarater variance on all occasions was reduced by 86 % and the interrater variance was reduced by 76 % when the Standardized Mini-Mental State was used; the reductions in variance were significant (p<O.003). The intraclass correlation for the Mini-Mental State was 0.69; for the standardized version it was 0.90. It took less time to administer the Standardized Mini-Mental State than the Mini-Mental State. Conclusions: The Standardized Mini-Mental State had better reliability than the Mini-Mental State in thi