The Association of Mini-Mental State Examination (MMSE) with Clinical Dementia Rating (CDR)

Objective: The purpose of our study is to i) determine if the Mini—Mental State Exam (MMSE) is a significant predictor of Clinical Dementia Rating (CDR) among elderly adults and ii.) to explore if measures of cognitive decline can improve the predictive power of a proposed statistical model. Participants: N=150 patients aged 60—96 from the United States enrolled in the second iteration of the Open Access Series of Imaging Studies (OASIS—2). Methods: Logistic Generalized Linear Mixed Models (GLMM) with random intercepts were used to examine the association of MMSE and CDR while considering covariates of age, MMSE, normalized whole brain volume (nWBV), and estimated total intracranial volume (eTIV). Results: MMSE was a statistically significant predictor of dementia (95% CI: 0.282—0.503; p—value <0.0001). For a given subject, the estimated odds of dementia via CDR scale will decrease by 62.3% for each unit increment in MMSE score after adjusting for age. There was strong evidence that the addition of nWBV improved the predictive power of the model (95% CI: 0.177—0.583; p—value = 0.0002), but not the addition of eTIV (95% CI: 0.582—1.434; p— value=0.6938). Conclusion: The significant association between MMSE and CDR is in agreement with previous research, indicating that the MMSE may provide a cost and time—effective clinical tool to predict the risk of dementia. Additionally, measures of brain volume, but not intracranial volume, appear to provide a valuable and additive predictive power related to dementia.