For this distinction, information on test–retest characteristics of the MMSE is indispensable. Thus the interpretation of individual changes in test scores requires judging whether the change is probably a result of a true clinical change (ie, is reliable) or can be explained by other factors with reasonable probability. Changes in MMSE test score may also be the result of measurement error, regression to the mean, practice effect as well as of normal aging. However, it has been recognised that not all changes in the MMSE score reflect true clinical improvement or decline (eg, see Tombaugh 2 and Schmand and colleagues 3). Improvement is an indicator of the response to therapy. Progressive cognitive decline is a hallmark of diseases leading to dementia.
The detection of decline or improvement is crucial for diagnosis and therapy.
In clinical as well as in research settings, it is often used to measure cognitive change over time in older adults.
The Mini‐Mental State Examination (MMSE) 1 is one of the most widely used screening instruments for dementia.
