The utility of the Modified Mini-Mental State Examination in inpatient rehabilitation for traumatic brain injury: preliminary findings.

Objective: The Modified Mini-Mental State Examination (3MS) could provide useful information about cognitive status in traumatic brain injury (TBI), yet has not been validated in this population. We studied the reliability, construct validity, clinical responsiveness, and cognitive impairment classification-ability of the 3MS compared to the Mini-Mental State Examination (MMSE).

Methods: Adult participants receiving inpatient rehabilitation services for TBI were administered the 3MS and MMSE at admission and discharge (n = 72). Construct validity and classification agreement were assessed through relationships of each measure with cognitive items of the Functional Independence Measure (FIM) and rehabilitation length of stay (LOS).

Results: 3MS reliability at admission and discharge (Cronbach's alphas = .871 and .839, respectively) exceeded that for the MMSE (Cronbach's alpha = .748 and .653, respectively). 3MS construct validity was marginally better than for the MMSE as assessed through correlations with FIM cognitive scores and LOS. Standard error of measurement as a percentage of the total scale was lower for the 3MS; responsiveness of the 3MS was superior as assessed by the 95% confidence interval for minimal detectable change. Cognitive impairment classification-ability was superior for the 3MS.

Conclusions: While both instruments had reasonable psychometric properties, the 3MS had a superior psychometric profile in the acute phase of TBI.