Validation of a telephone version of the mini-mental state examination

J Am Geriatr Soc. 1992 Jul;40(7):697-702. doi: 10.1111/j.1532-5415.1992.tb01962.x.


Objective: To assess the construct validity of a telephone-administered version of the Mini-Mental State Examination (MMSE).

Design: Validity testing by comparing a telephone version of the MMSE administered first to a face-to-face evaluation done several days later.

Setting: Outpatient geriatric assessment center.

Subjects: 100 of 175 consecutive referrals.

Main outcome measures: MMSE and a brief neuropsychological screening test (BNPS) face-to-face and a telephone version of the MMSE as part of the Adult Lifestyles and Function Interview (ALFI-MMSE).

Results: Test scores of the two MMSE versions correlated strongly for all subjects (Pearson's r = 0.85, P = 0.001) and remained significant for the cognitively intact (P = 0.02) and questionably (P = 0.002), mildly (P = 0.0001), and moderately (P = 0.003) demented. Comparison of the two versions' equivalent 22 items revealed no significant difference for scores of all subjects (P = 0.07) but with a trend toward higher scores in the original version. Diminished hearing, reported either by the subject (P = 0.003) or by the collateral source (P = 0.02) was associated with lower scores on the telephone version. Five individual test items were biased by the route of test administration. Sensitivity and specificity relative to the BNPS were 67% and 100% for the ALFI-MMSE and 68% and 100% for the MMSE, respectively.

Conclusion: The scores on the ALFI-MMSE correlated strongly with the scores of the original version given face-to-face in subjects undergoing geriatric assessment. The results indicate that the ALFI-MMSE could be a useful and economical tool to screen for cognitive impairment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / epidemiology
  • Educational Status
  • Evaluation Studies as Topic
  • Female
  • Geriatric Assessment*
  • Hospitals, University
  • Humans
  • Male
  • Marriage / statistics & numerical data
  • Mass Screening
  • Mental Status Schedule / standards*
  • Nebraska / epidemiology
  • Outpatient Clinics, Hospital
  • Racial Groups
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Telephone / statistics & numerical data*