Reliability of the MMSE administered in-person and by telehealth

Can J Neurol Sci. 2008 Nov;35(5):643-6. doi: 10.1017/s0317167100009458.


Background: Recent advances in telehealth have improved access to health care for those in rural areas. It is important that examinations conducted via telehealth are comparable to in-person testing. A rural and remote memory clinic in Saskatoon provided an opportunity to compare scores on the Mini-Mental State Examination (MMSE) administered in-person and via telehealth.

Methods: After an initial one day assessment in Saskatoon, patients were seen in follow-up at 6 and 12 weeks. Individual patients were randomly assigned to either in-person follow-up assessment in Saskatoon or telehealth assessment in their home community. Patients who initially received in-person assessments were seen by telehealth for their next follow-up visit and vice-versa. The same neurologist administered MMSEs at all visits. The first 71 patients with both 6 and 12 week follow-up assessments were included in this study. The scores of in-person and telehealth MMSE administrations were compared using the methods of Bland and Altman as well as a paired t-test.

Results: MMSE scores did not differ significantly between telehealth (22.34 +/- 6.35) and in-person (22.70 +/- 6.51) assessments.

Conclusion: Telehealth provides an acceptable means of assessing mental status of patients in remote areas.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cognition Disorders / diagnosis
  • Data Collection
  • Female
  • Health Status*
  • Humans
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / epidemiology
  • Middle Aged
  • Neuropsychological Tests / statistics & numerical data*
  • Psychiatric Status Rating Scales
  • Psychometrics
  • Remote Consultation / methods
  • Remote Consultation / statistics & numerical data
  • Reproducibility of Results
  • Rural Population
  • Saskatchewan
  • Telemedicine / methods*
  • Telemedicine / statistics & numerical data*
  • Videoconferencing / statistics & numerical data*