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Re-examining popular screening measures in neuro-oncology: MMSE and RBANS

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Abstract

Background

The Mini-Mental Status Examination (MMSE) is routinely used in neuro-oncology clinics to rule out cognitive impairment. However, the MMSE is known to have poor sensitivity to mild cognitive impairment, raising concern regarding its continued use. More comprehensive cognitive screeners are available, such as the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and may be better able to assess for cognitive dysfunction.

Methods

This retrospective cross-sectional study compared the relative rates of impairment using the MMSE-2 and RBANS in a sample of neuro-oncology patients (N = 81). A preliminary analysis of the sensitivity and specificity of the MMSE-2 to the level of cognitive impairment identified on the RBANS was conducted; in addition, we examined whether an adjustment of the MMSE-2 cut-off score improved consensus with a positive screening on the RBANS.

Results

The MMSE-2 failed to identify over half of the patients with cognitive dysfunction that were identified on the RBANS. Further analysis showed limited sensitivity of the MMSE-2 to the level of impairment detected on the RBANS, and an adjustment of the cut-off score did not improve the sensitivity or specificity of the MMSE-2.

Conclusions

These results provide caution for neuro-oncology clinics using the MMSE. If providers continue to rely on the MMSE to screen for cognitive impairment alone, they may fail to identify individuals with mild cognitive impairments.

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Authors and Affiliations

  1. Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA

    Farah Aslanzadeh, Julia Brechbiel & Kelcie Willis

  2. Division of Neuro-Oncology, Department of Neurology, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA

    Sarah Braun & Ashlee Loughan

  3. Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA

    Sarah Braun, Autumn Lanoye & Ashlee Loughan

  4. School of Education and Human Development, University of Virginia, Charlottesville, VA, USA

    Kyra Parker

  5. Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    Autumn Lanoye

Authors
  1. Farah Aslanzadeh
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  2. Sarah Braun
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  7. Ashlee Loughan
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Farah Aslanzadeh, PhD; Sarah Braun, PhD; Julia Brechbiel, PhD; Kelcie Willis, MS; Autumn Lanoye, PhD; and Ashlee Loughan, PhD. The first draft of the manuscript was written collaboratively by Farah Aslanzadeh, PhD; Julia Brechbiel, PhD; and Kelcie Willis, MS; and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ashlee Loughan.

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Ethics approval

The questionnaire and methodology for this study were approved by the Human Research Ethics committee of the Virginia Commonwealth University (ethics approval number: HM20005129).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Aslanzadeh, F., Braun, S., Brechbiel, J. et al. Re-examining popular screening measures in neuro-oncology: MMSE and RBANS. Support Care Cancer 30, 8041–8049 (2022). https://doi.org/10.1007/s00520-022-07213-0

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  • DOI: https://doi.org/10.1007/s00520-022-07213-0

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