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Screening for cognitive impairment in multiple sclerosis. An evaluation of the Mini-Mental State Examination
Beatty WW, Goodkin DE.. Archives of neurology, 1990-03-01
Topic: Risk, prevention and care in population studies
The usefulness of the Mini-Mental State Examination (MMSE) as a screening test for identifying cognitive impairment in patients with multiple sclerosis (MS) has been questioned because many patients who score above the suggested cutoff score of 24 exhibit severe focal or global cognitive deficits. We reevaluated the usefulness of the MMSE by studying 85 patients with clinically definite MS who also received an extensive battery of neuropsychological tests. Although scores on the MMSE were negatively correlated with the number of neuropsychological tests on which patients with MS displayed impairment, the MMSE was not sufficiently sensitive to identify precisely defined dementia in these patients.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Beatty, W. W., & Goodkin, D. E. (1990). Screening for cognitive impairment in multiple sclerosis. An evaluation of the Mini-Mental State Examination. Archives of neurology. https://doi.org/10.1001/archneur.1990.00530030069018
Vancouver
Beatty WW, Goodkin DE. Screening for cognitive impairment in multiple sclerosis. An evaluation of the Mini-Mental State Examination. Archives of neurology. 1990. doi:10.1001/archneur.1990.00530030069018. PMID: 2310313.
BibTeX
@article{beatty1990-2310313,
author = {Beatty, W. W. and Goodkin, D. E.},
title = {{Screening for cognitive impairment in multiple sclerosis. An evaluation of the Mini-Mental State Examination}},
journal = {Archives of neurology},
year = {1990},
doi = {10.1001/archneur.1990.00530030069018},
pmid = {2310313},
url = {https://doi.org/10.1001/archneur.1990.00530030069018}
}
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Key findings
- We reevaluated the usefulness of the MMSE by studying 85 patients with clinically definite MS who also received an extensive battery of neuropsychological tests.
- Although scores on the MMSE were negatively correlated with the number of neuropsychological tests on which patients with MS displayed impairment, the MMSE was not sufficiently sensitive to identify precisely defined dementia in these patients.
- The MMSE was nonetheless a useful predictor of focal cognitive impairment, particularly in relapsing-remitting patients with relatively minor physical disabilities.
- Additional analyses suggested strategies for minor modifications of the MMSE that may improve its sensitivity and specificity for identifying dementia while preserving its major advantages as a screening examination: brevity and ease of administration and scoring.
Why it matters
This study evaluated the Mini-Mental State Examination as a screening test in 85 patients with multiple sclerosis, not Alzheimer's disease. It found the test was not sensitive enough to identify dementia in these patients and does not address treating, curing, or preventing Alzheimer's disease.
Study details
- Participants85
- Evidence strengthLow
How this study scored 45/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of neurology) |
| Journal's citation record | 3 / 4 | Archives of Neurology: journal h-index 353 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1990 — older than 20 years, still counted |
| Sample size | 1 / 4 | 85 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 197 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.2 citations a year over 38 year(s) since 1990 |
| Impact for its field and year | 3 / 6 | Cited 6.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 2 / 4 | Cited 17 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author William W. Beatty: h-index 60 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Neuropsychiatric Research Institute: institution h-index 176 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 2310313) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 45 / 100 | — |
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