J Korean Neuropsychiatr Assoc.  2008 Mar;47(2):153-160.

Reliability and Validity of the Korean Version of Severe Mini-Mental Status Examination (SMMSE-K)

  • 1Saint Andrew's Neuropsychiatric Hospital, Icheon, Korea.
  • 2Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea. kwkimmd@snu.ac.kr
  • 3Kyunggi Provincial Hospital for the Elderly, Yongin, Korea.
  • 4Department of Psychiaty, Kyung Hee University Medical Center, Seoul, Korea.
  • 5Department Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
  • 6Gongju National Hospital, Gongju, Korea.
  • 7Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, Korea.
  • 8Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.


We developed the Korean version of Severe Mini-Mental Status Examination (SMMSE-K) which is a brief cognitive test for the severely demented patients.
The translation was carried out keeping the basic structure of the English version Severe Mini-Mental Status Examination (SMMSE). The SMMSE-K, Korean version of Mini Mental State Examination (MMSE-KC), and Clinical Dementia Rating (CDR) were administered to 84 Alzheimer's disease (AD) patients and 36 cognitively normal elderly subjects. For evaluating the reliability of the SMMSE-K, Cronbach alpha coefficient, inter-rater reliability, and test-retest reliability were examined. For confirming the validity of the SMMSE-K, the correlations of the SMMSE-K with MMSE-KC and CDR were examined, and factor analysis was performed using principal component analysis with Varimax rotation.
SMMSE-K was found to have a high internal consistency (Cronbach alpha coefficient=0.906, p<0.01), inter-rater reliability (Pearson correlation coefficient=0.980, p<0.01) and test-retest reliability (Pearson correlation coefficient=0.940, p<0.01). Performances on the SMMSE-K and MMSE-KC were found to correlate significantly in the subjects with CDR of 2 (Pearson correlation coefficient=0.827, p<0.001) and 3 (Pearson correlation coefficient=0.929, p<0.001). In the subjects with CDR of 3, the MMSE-KC showed a floor effect (2.93+/-3.21), whereas the SMMSE-K did not (11.00+/-8.48). Exploratory factor analysis yielded two factors (automatic informational processing, controlled informational processing) accounting for 76.1% of the total variance.
The SMMSE-K was found to be a reliable and valid test for assessing the cognition of severely demented patients.


Korean Version of Severe Mini-Mental Status Examination (SMMSE-K); Severe dementia; Reliability; Validity
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