ABSTRACT
The Minimental State Examination (MMSE), created in 1975 as a tool for briefly evaluating the patient's mental state, has been widely used and is the most frequently cited cognitive test on Medline, as well as being the one with the most versions in different languages (over 70). Through a review of the Medline database, this paper aims to analyse its virtues and shortcomings, in addition to determining its current clinical usefulness, in both the original version and any of its modifications, although here we are mainly concerned with its Spanish adaptations. The MMSE (original or versions) is the most commonly used test for standardised cognitive assessment in the clinical setting, especially in the case of the elderly. It is the test with the most data for screening, staging and monitoring dementias. Yet, because filling it in may take over 10 minutes, it has to compete with shorter, more specific screening tests in the primary care and community setting. In the hospital and specialised setting, there is a need for broader standardised neuropsychological tests that make it possible to detect subtle cognitive disorders in patients with incipient dementia or mild cognitive impairment, as well as to establish a cognitive profile of the different subtypes of dementia. This study proposes a series of recommendations on the clinical use of the Spanish versions of the MMSE in different contexts of application.
TITLE: Versiones en español del Minimental State Examination (MMSE). Cuestiones para su uso en la practica clinica.El Minimental State Examination (MMSE), creado en 1975 como instrumento para la evaluacion breve del estado mental, ha tenido una gran difusion, y es el test cognitivo mas citado en Medline y con mayor numero de versiones idiomaticas (superiores a 70). Este articulo pretende, mediante una revision en la base de datos Medline, analizar sus virtudes y limitaciones, ademas de precisar su utilidad clinica actual, tanto de la version original como de sus modificaciones, principalmente de las adaptaciones al español. El MMSE (original o versiones) es el test mas utilizado para la evaluacion cognitiva estandarizada en el ambito clinico, sobre todo en el anciano. Es el que dispone de mas datos para el cribado, estadiaje y seguimiento de las demencias. Sin embargo, dado que su cumplimentacion puede requerir mas de 10 minutos, ha de competir con tests de cribado mas cortos y especificos en atencion primaria y el medio comunitario. En el ambito hospitalario y especializado, se precisan evaluaciones neuropsicologicas estandarizadas mas amplias que permitan detectar alteraciones cognitivas sutiles en pacientes con demencia incipiente o alteracion cognitiva leve, ademas de establecer un perfil cognitivo de los diferentes subtipos de demencias. Este trabajo realiza una serie de recomendaciones sobre el uso clinico de las versiones españolas del MMSE en diferentes contextos de aplicacion.