Sensitivity and specificity of the mini-mental state examination for identifying dementia in the oldest-old: the 90+ study

OBJECTIVES: To evaluate the sensitivity and specificity of the Mini-Mental State Examination (MMSE) in identifying dementia in the oldest-old when stratified by age and education. DESIGN: Cross-sectional. SETTING: Research clinic and in-home visits. PARTICIPANTS: Population-based sample of adults aged 90 and older (n=435) who are enrolled in the 90+ Study, a longitudinal, population-based study. MEASUREMENTS: Neurological examination to determine dementia diagnosis, MMSE, and demographic data. RESULTS: Receiver operating characteristic (ROC) analyses indicated that the MMSE had high diagnostic accuracy for identifying dementia in subjects aged 90 and older across different age and education groups (area under the ROC curve values ranged from 0.82 to 0.98). A range of possible cutoff values and corresponding sensitivity and specificity are provided for the following age groups: 90-93, 94-96, and >or=97. Age groups were subdivided by educational attainment (