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To analyze the diagnostic performance of the Mini-Mental State Examination (MMSE) for screening dementia in primary care and to investigate whether clinical variables are predictive of a score < or = 23. Observational, transversal, and multicenter study. One hundred seventy-four patients consecutively seen in 25 primary care centers in Navarra (Spain). Primary care setting. First follow-up by caregiver; second evaluation by an interviewer as a member of the study. Scoring of MMSE in screening phase (first evaluation) and in validation phase (last evaluation). The prevalence of dementia was 2.6%. The predictive values of a score < or = 23 at first evaluation were: sensitivity, 48.9%; specificity, 96.7%; positive predictive value, 38.0%; negative predictive value, 97.1%; positive likelihood ratio, 5.9; and negative likelihood ratio, 0.1. The predictive variables of an MMSE score < or = 23 at first evaluation were age (OR = 1.1; 95% CI, 1.0-1.2), the presence of Parkinson's disease (OR = 13.8; 95% CI, 2.1-89.9), and the presence of depression (OR = 2.8; 95% CI, 1.1-7.6). The predictive variables of an MMSE score < or = 23 at second evaluation were age (OR = 1.1; 95% CI, 1.0-1.1), the presence of Parkinson's disease (OR = 20.1; 95% CI, 1.9-204), the presence of depression (OR = 12.8; 95% CI, 2.1-76.3), and an MMSE score < or = 23 at first evaluation (OR = 5.1; 95% CI, 1.1-23.1). The MMSE is useful for screening dementia in primary care, but with a low predictive value and, in any case, a low sensitivity. Some variables related to the sample and to the study design must be taken into consideration in 0b46394aab
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