Validation of a Telephone Version of the Mini‐Mental State Examination

To assess the construct validity of a telephone‐administered version of the Mini‐Mental State Examination (MMSE). Validity testing by comparing a telephone version of the MMSE administered first to a face‐to‐face evaluation done several days later. Outpatient geriatric assessment center. 100 of 175 consecutive referrals. 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). 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. 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.