When mild impairment is not safe: mini-mental state examination scores of ≤21 are associated with emergency response failure.

Introduction: Unrecognized emergency-response deficits contribute to preventable harm and loss of independence in older adults with cognitive decline. Although the Mini-Mental State Examination (MMSE) is widely used to assess global cognition, clinicians often use MMSE scores to inform judgments abo...

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Publicado en:Frontiers in Aging Neuroscience pp. 1 - 9
Autores principales: Kim, Howard, Parker, Caitlyn, Severance, Jennifer Jurado, Wiechmann, April
Formato: pictorial research tables/charts Journal Article
Publicado: Frontiers Media S.A. 2026
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Frontiers in Aging Neuroscience
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      dt: 2026
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      pub: Frontiers Media S.A.
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        10.3389/fnagi.2026.1916712
        196388326
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        atl: When mild impairment is not safe: mini-mental state examination scores of ≤21 are associated with emergency response failure.
      aug:
        au:
          Kim, Howard
          Parker, Caitlyn
          Severance, Jennifer Jurado
          Wiechmann, April
        affil: UNT Health Fort Worth Texas College of Osteopathic Medicine, Fort Worth, TX, United States
      sug:
        subj:
          Mild Cognitive Impairment Risk Factors
          Executive Function
          Psychological Tests
          Emergency Service
          Predictive Value of Tests
          Risk Assessment
          Human
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Texas
          Academic Medical Centers
          Retrospective Design
          Record Review
          Cross Sectional Studies
          Comparative Studies
          Descriptive Statistics
          Data Analysis Software
          Questionnaires
          Pearson's Correlation Coefficient
          Fisher's Exact Test
          ROC Curve
          Logistic Regression
          Age Factors
          Sex Factors
          Race Factors
          Memory, Short Term
          Problem Solving
          Attention
          Motor Skills
          Psychomotor Performance
          Task Performance and Analysis
          Neuropsychological Tests
          Diagnosis, Psychosocial
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Introduction: Unrecognized emergency-response deficits contribute to preventable harm and loss of independence in older adults with cognitive decline. Although the Mini-Mental State Examination (MMSE) is widely used to assess global cognition, clinicians often use MMSE scores to inform judgments about everyday functioning. However, the relationship between MMSE performance and emergency-response ability remains unclear. The Test of Executive Functioning in an Emergency (TEFE) is a brief, performance-based assessment that evaluates a patient's ability to relay critical information and contact emergency services. This study examined whether an MMSE threshold was associated with failure on TEFE 911 tasks. Methods: A retrospective analysis included 905 patients from a university-affiliated memory clinic with Alzheimer's disease, vascular dementia, mixed dementia, mild cognitive impairment, or normal cognition. Associations between MMSE scores and TEFE 911 knowledge and behavioral task failure were examined using correlation, adjacent-score comparisons, receiver operating characteristic (ROC) analyses, Youden's J , and multivariable logistic regression adjusted for demographic and diagnostic covariates. Results: MMSE and TEFE scores were moderately correlated (r = 0.596, p < 0.0001). Failure rates were higher at MMSE scores of 21 than 22. ROC analyses demonstrated good discrimination for 911 task failure (AUC = 0.860–0.867). An MMSE cutoff of ≤21 yielded 61.9% sensitivity and 88.9% specificity for failure on 911 tasks and remained independently associated with failure after adjustment (adjusted OR = 3.71, 95% CI: 1.82–7.56). Discussion: Patients with MMSE scores ≤21 may warrant further performance-based assessment of emergency-response ability. Prospective studies should determine whether this threshold predicts real-world safety outcomes.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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