Compassion Versus Accuracy: Lenient Scoring of the Spatial Orientation Items on the Mini-mental State Exam Lowers Sensitivity

We examined the effect of lenient SOE scoring on MMSE classification accuracy in a consecutive case series of 103 older adults (age 60 or above) clinically referred for neuropsychological evaluation. Lenient scoring of SOEs on the MMSE occurred in 53 (51.4%) patients and lowered the sensitivity by 7% to 18%, with variable gains in specificity (0% to 11%) to psychometrically operationalized cognitive impairment. Results are consistent with previous reports that lenient scoring is widespread and attenuates the sensitivity of the MMSE. Given the higher clinical priority of correctly detecting early cognitive decline over specificity, a warning against lenient scoring of SOEs (on the MMSE and other screening tools) during medical education and in clinical practice is warranted.PMID:38300875 | DOI:10.1097/WAD.0000000000000609

Source: Alzheimer Disease and Associated Disorders - February 1, 2024 Category: Psychiatry Authors: Katrina Kent Nesrine Adly Ibrahim Kristoffer Romero Shannon Baker Matthew Greenacre Chantal M Boucher Robert M Roth Laszlo A Erdodi Source Type: research