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Diagnostic Accuracy of the MMSE in Detecting Probable and Possible Alzheimer's Disease in Ethnically Diverse Highly Educated Individuals: An Analysis of the NACC Database

2012; Oxford University Press; Volume: 67; Issue: 8 Linguagem: Inglês

10.1093/gerona/gls006

1758-535X

Cynthia C. Spering, Valerie Hobson, John A. Lucas, Chloe V. Menon, Julia R. Hall, Sid E. O’Bryant,

Health, Environment, Cognitive Aging

T HE Mini-Mental State Examination (MMSE) ( 1 ) is a commonly administered measure of global cognitive functioning that is used to track change, screen for cognitive impairment, and measure outcome in clinical trials.The MMSE has been shown to be relatively sensitive to overt dementia ( 2 -4 ), although its utility decreases when assessing patients with psychiatric conditions and mild cognitive decline ( 5 -7 ) .MMSE performance is moderated by education and age, with less educated and older individuals tending to receive lower scores ( 5 , 8 ) .Ethnic minority groups also tend to obtain lower scores than Caucasians; however, ethnicity is often confounded with lower levels of education, particularly in older cohorts who were raised in a segregated educational system ( 9 ) .Moreover, Ostrosky and colleagues ( 8 ) observed a similar confound among Spanish speakers, in that , diagnostic validity (ie, sensitivity and specifi city) of the MMSE was found to be better among Spanish speakers with more education compared with those with lower levels of education.Correction formulas have been developed to adjust the negative effects of age and education on MMSE scores ( 5 ) but have met with varying levels of success ( 10 ).