gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

The assessment of changes in cognitive functioning in the elderly: Age- and education-specific Reliable Change Indices for the Mini-Mental State Examination (MMSE). Results of the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe)

Meeting Abstract

  • Janine Stein - Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Leipzig
  • Melanie Luppa - Institute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Leipzig
  • Wolfgang Maier - Department of Psychiatry, University of Bonn, Bonn
  • Hendrik van den Bussche - Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg
  • Martin Scherer - Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg
  • Horst Bickel - Department of Psychiatry, Technical University of Munich, Munich
  • Siegfried Weyerer - Central Institute of Mental Health, Mannheim, Mannheim
  • Michael Pentzek - Department of General Practice, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf
  • Birgitt Wiese - Institute for Biometrics, Hannover Medical School, Hannover
  • Hans-Helmut Koenig - Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg
  • Steffi G. Riedel-Heller - Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds358

doi: 10.3205/11gmds358, urn:nbn:de:0183-11gmds3581

Published: September 20, 2011

© 2011 Stein et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Background/Aims: The Mini-Mental State Examination (MMSE) represents a commonly used neuropsychological screening instrument to measure general cognitive functions in the elderly. The diagnosis of dementia includes evidence of decline in cognitive functioning over time in objective cognitive tasks. Normative data for changes adjusted for the impact of socio-demographic factors (e.g. age and education) on cognitive test performance is lacking to interpret changes in MMSE test scores.

Methods: As part of the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe Study), a sample of 1,090 cognitively healthy individuals, aged 75 years and over at baseline, was assessed four times at 1.5 year intervals over a period of approximately 4.6 years using the MMSE. Age- and education-specific Reliable Change Indices (RCIs) were computed for a 90% confidence interval.

Results: MMSE test scores were subject to influence by age and education. Across different age and education subgroups, changes from at least 2 up to 3 points indicated significant (i.e. reliable) changes in MMSE test scores at the 90% confidence level. Furthermore, the calculation of RCIs for individual patients is demonstrated.

Conclusion: This study provides age- and education-specific MMSE reference values based upon RCI methods for the interpretation of cognitive changes in older age groups. The computation of RCI scores improves the interpretation of changes in MMSE test scores by controlling for possible impact of measurement error, practice effects or regression to the mean.