Article
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)
Search Medline for
Authors
Published: | September 20, 2011 |
---|
Outline
Text
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.