The distribution of Mini‐Mental State Examination scores in an older UK African–Caribbean population compared to MRC CFA study norms

Abstract

Objective To describe normative data for the Mini‐Mental State Examination (MMSE) in a UK African–Caribbean population and compare these with norms for white UK‐born elders. Design A comparison of MMSE data from two cross‐sectional surveys. Method The MMSE had been administered to a community UK African–Caribbean population and scores were compared to norms from the Medical Research Council Cognitive Function and Ageing Study (CFAS). MMSE data were analysed for 248 African–Caribbean participants aged 55–75 and 5379 CFAS participants aged 65–74, without visual or auditory problems. Distributions of scores were tabulated and error rates for individual items compared. Results Median MMSE scores were 25 (interquartile range 22–27) for the whole African–Caribbean sample, 24 (22–27) for those aged 65–75 in the African–Caribbean sample, and 27 (25–29) for CFAS. Differences in error rates were specific to particular items: naming the season, serial seven subtraction, phrase repetition, three‐stage command, and copying intersecting pentagons. These differences persisted when both samples were restricted to those with statutory duration of education, who were literate and who had worked in non‐manual occupations. Normative data are displayed for MMSE scores in both groups. Conclusion Different distributions of MMSE scores between UK African–Caribbean and Caucasian groups can be principally explained by cultural bias in certain items. If the MMSE is to be administered to older African–Caribbean people, specific normative data should be referred to or else a culturally modified version of the instrument should be used. Copyright © 2002 John Wiley & Sons, Ltd.