Diagnostic Validity of Age and Education Corrections for the Mini‐Mental State Examination in Older African Americans
- 8 December 2011
- journal article
- other
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 60 (2), 328-331
- https://doi.org/10.1111/j.1532-5415.2011.03766.x
Abstract
Objectives To investigate whether demographic (age and education) adjustments for the Mini‐Mental State Examination (MMSE) attenuate mean score discrepancies between African‐American and Caucasian adults and whether demographically adjusted MMSE scores improve the diagnostic classification accuracy of dementia in African‐American adults over unadjusted MMSE scores. Design Cross‐sectional study. Setting Community‐dwelling adults participating in the Mayo Clinic Alzheimer's Disease Patient Registry and Alzheimer's Disease Research Center. Participants Three thousand two hundred fifty‐four adults (2,819 Caucasian, 435 African American) aged 60 and older. Measurements MMSE score at study entry. Results African‐American adults had significantly lower unadjusted MMSE scores (23.0 ± 7.4) than Caucasian adults (25.3 ± 5.4). This discrepancy persisted despite adjustment of MMSE scores for age and years of education using established regression weights or newly derived weights. Controlling for dementia severity at baseline and adjusting MMSE scores for age and quality of education attenuated this discrepancy. In African‐American adults, an age‐ and education‐adjusted MMSE cut score of 23/24 provided optimal dementia classification accuracy, but this represented only a modest improvement over an unadjusted MMSE cut score of 22/23. The posterior probability of dementia in African‐American adults is presented for various unadjusted MMSE cut scores and prevalence rates of dementia. Conclusion Age, dementia severity at study entry, and quality of educational experience are important explanatory factors in understanding the existing discrepancies in MMSE performance between Caucasian and African‐American adults. These findings support the use of unadjusted MMSE scores when screening older African Americans for dementia, with an unadjusted MMSE cut score of 22/23 yielding optimal classification accuracy.Keywords
This publication has 9 references indexed in Scilit:
- Detecting Dementia With the Mini-Mental State Examination in Highly Educated IndividualsArchives of Neurology, 2008
- Acculturation, Reading Level, and Neuropsychological Test Performance Among African American EldersApplied Neuropsychology, 2004
- Reading level attenuates differences in neuropsychological test performance between African American and White eldersJournal of the International Neuropsychological Society, 2002
- Clinical Dementia Rating: A Reliable and Valid Diagnostic and Staging Measure for Dementia of the Alzheimer TypeInternational Psychogeriatrics, 1997
- Age and education correction of Mini-Mental State Examination for English- and Spanish-speaking elderlyNeurology, 1996
- Correlates of mini-mental status examination scores among elderly demented patients: The influence of race-ethnicityJournal of Clinical Epidemiology, 1994
- Mayo's older americans normative studies: WAIS-R norms for ages 56 to 97The Clinical Neuropsychologist, 1992
- Use of the Mini-Mental State Examination (MMSE) in a Community Population of Mixed EthnicityJournal Of Nervous and Mental Disease, 1986
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975