The Validity and Reliability of the Korean Modified Mini-Mental State (K-3MS) Examination

Sohn, Eun Hee; Lee, Ae Young; Park, Hyun Ju

Abstract

BACKGROUND
The Folstein Mini-Mental State Examination (MMSE) is a well-established and reliable cognitive screening instrument. However, recent investigations have reported limitations in the MMSE as a cognitive screening tool. The Modified Mini-Mental State Examination (3MS) taps a broader range of cognitive abilities by including evaluations of semantic fluency, delayed memory, remote personal information, and abstraction as well as those areas included in the MMSE. We report age- and education-specific reference values of the Korean Modified Mini-Mental State (K-3MS) Examination and the MMSE in the non-demented elderly population. We also evaluate the validity and reliability of the K-3MS for cognitive screening. METHODS: The K-3MS and the MMSE were administered to 112 dementia patients and 99 controls, aged 50~90 years old. K-WAIS, K-DRS, CDR were done with K-3MS in dementia patients. Test-retest reliability coefficients were obtained from 50 patients. NINCDS-ADRDA criteria for probable AD and NINDS-AIREN criteria for VaD were used. RESULTS: The K-3MS correlated with the MMSE (r=0.94, p<0.05). The area under the receiver operating characteristic (ROC) curve for the K-3MS was 0.872 and for the MMSE was 0.865. There was no statistically significant difference between both tests. The sensitivity and specificity of the K-3MS (cutoff score=72) for a dementia diagnosis were 0.83, 0.78 and those of the MMSE (cut-off score=23) were 0.78, 0.74. The K-3MS was found to have high test-retest reliability (r=0.93). CONCLUSIONS: The K-3MS is a reliable, valid, and stable cognitive screening instrument. The K-3MS is comparable to the MMSE as a dementia screening test.