Date of Completion
2024
Document Type
Honors College Thesis
Department
Nursing
Thesis Type
Honors College
First Advisor
Mary Val Palumbo DNP, APRN, GNP-BC
Keywords
Mini-Mental State Examination, Dementia, Telehealth
Abstract
Background: Since the beginning of the COVID-19 pandemic in March of 2020, telehealth access in the United States has greatly expanded. This resulted in the Mini-Mental State Examination (MMSE) being administered to patients with cognitive impairment via telehealth far more frequently, raising the question of if the MMSE is a reliable tool in this telehealth format. This study is a continuation of (Greenough & Palumbo, 2022) “Evaluation of Cognitive Testing Done by Telehealth Visit,” which concluded that there is no statistically significant difference in MMSE scores when performed in-person versus via telehealth. Purpose: The aim of this study was to improve the validity of the previous findings (Greenough & Palumbo, 2022) in order to further support the use of the MMSE via telehealth. Methods: A retrospective chart review of patients seen between November 1, 2021 and August 1, 2023 was conducted. Linear regression was utilized to calculate the slope of each patient’s MMSE score per year. The MMSE slope was compared for in-person and telehealth assessments using the Wilcoxon signed rank tests. Odds ratios were calculated to compare patients whose MMSE scores did not decrease versus did decrease. Results: The median (IQ range) change in MMSE score per year for telehealth visits was -1.6 (-4.3 - 0.0). The median (IQ) change in MMSE score per year for in-person visits was -0.9 (-1.8 - -0.1). The Wilcoxon signed rank test yielded a result of p = 0.05. The odds ratio (OR) for no decrease in score for under 65 years of age vs 65-85 years of age = 2.26 (95% CI 0.48-10.67, p = 0.30). The OR for no decrease in score for over 85 years of age vs 65-85 years of age = 0.17 (95% CI 0.02-1.38, p = 0.10). For MCI, the OR for no decrease in score for Yes vs No = 2.22 (95% CI 0.93-5.30, p = 0.07). For Late onset Alzheimer’s, the OR for no decrease in score for Yes vs No = 0.51 (95% CI 0.23-1.12, p = 0.09). Conclusion: Although there was a greater decrease in MMSE scores across telehealth visits versus in-person which was found to be marginally significant, this difference is not clinically meaningful. Therefore, this study supports the findings of the first part of this study (Greenough & Palumbo, 2022) that the administration of the MMSE via telehealth does not result in a clinically significant difference in scores compared to when administered in-person. Consequently, it is reasonable for practitioners to use the MMSE in the telehealth setting to monitor cognitive decline in patients with dementia and direct their care.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Recommended Citation
Dargie, Alexa, "Mini-Mental State Examination Reliability: In-Person versus Telehealth in Patients with Dementia" (2024). UVM Patrick Leahy Honors College Senior Theses. 622.
https://scholarworks.uvm.edu/hcoltheses/622