Table 5.
Summary of findings for PICO 8. Assessment of the diagnostic accuracy of Folstein’s Mini-Mental State Examination for contemporaneous diagnosis of post-stroke cognitive impairment or dementia.
| Participants: Stroke
survivors Settings: Variety (acute and post-acute) Intervention: Mini-Mental State Examination (MMSE) Reference standard: Clinical dementia diagnosis or multidomain impairment | ||||
| Test | Summary sensitivity Summary specificity |
N participants/N with dementia | Risk of bias | GRADE |
| MMSE all studies at ‘best’ performing reported threshold | Sens: 0.73 (0.62–0.82) Spec: 0.79 (0.72–0.85) |
Sixteen studies 1655 participants 660 PSCI |
High | Low a |
| MMSE ‘acute’ time period | Sens: 0.80 (0.66–0.89) Spec: 0.74 (0.59–0.85) |
Nine studies 806 participants 393 PSCI |
High | Low a |
| MMSE ‘chronic’ time period | Sens 0.60 (0.46–0.72) Spec 0.81 (0.75–0.86) |
Four studies 651 participants 211 PSCI |
High | Low a |
| MMSE threshold 23 (+/−1) |
Sens: 0.74 (0.58–0.85) Spec: 0.82 (0.78–0.86) |
Seven studies 704 participants 257 PSCI |
High | Low a |
| MMSE threshold 26 (+/−1) |
Sens: 0.72 (0.56–0.84) Spec: 0.76 (0.62–0.86) |
Nine studies 951 participants 403 PSCI |
High | Low a |
aDowngraded due to risk of bias and precision.
Acute refers to less than 3 months since stroke.
PSCI = Post-stroke cognitive impairment (including post-stroke dementia).