Illiteracy and poor schooling is still a major problem in developing countries. As life expectancy is increasing steadily, these countries have many illiterate elderly at risk of developing dementia. In fact, illiteracy has been considered a risk factor for dementia, along with age, female gender, and living cional (analfabetos/alfabetizados: OR=15,60; p=0/ OR = 16,40; p=0). Idade e gênero são fatores associados a comprometimento cognitivo/funcional (p<0,05). A prevalência de comprometimento cognitivo/funcional é mais alta que a encontrada em outro estudo brasileiro. Idade, gênero feminino e comprometimento funcional estão diretamente associados a comprometimento cognitivo. O reconhecimento de comprometimento funcional pode ser mais fácil por familiares/profissionais de saúde. Isso reforça a idéia do uso combinado de escalas em rastreamentos de demência. PREVALENCE OF COGNITIVE AND FUNCTIONAL IMPAIRMENT IN COMMUNITY-DWELLING ELDERLYPA L AV R A S -C H AVE: Status funcional, comprometimento cognitivo, epidemiologia, prevalência, fatores de risco

The objective of this study was to assess Mini-Mental State Examination norms of a functionally normal sample of community-dwelling elderly. Illiterate and low-educated subjects who scored less than 5 on the Pfeffer Functional Activities Questionnaire (PFAQ) [n = 397; female = 269; mean age = 72.15 (SD = 7.24) years] had the 5th, 25th, 50th, and 75th percentiles calculated according to age (65-74; 75-84 years). Overall MMSE score was 21.97 (SD = 4.48). Mean MMSE for illiterate younger individuals was 19.46 (SD = 3.47), and the quartile distribution was 14, 17, 19, and 21. MMSE of subjects with 1-8 years of schooling was 23.90 (3.87), and the distribution was 15, 22, 24, and 27. MMSE of older illiterate subjects was 18.11 (SD = 3.63), and the distribution of scores was 13, 16, 18, and 20, whereas subjects with 1-8 years of schooling scored 23.81 (SD = 4.01) and the distribution was 15, 22, 24, and 27. These MMSE normative data may help improve the detection of cognitive impairment in Brazil, mainly in the primary clinical setting.

Mini-mental state examination in community-dwelling elderly: preliminary data from Santo Antônio de Mini-mental state examination in community-dwelling elderly: preliminary data from Santo Antônio de Mini-mental state examination in community-dwelling elderly: preliminary data from Santo Antônio de Mini-mental state examination in community-dwelling elderly: preliminary data from Santo Antônio de Mini-mental state examination in community-dwelling elderly: preliminary data from Santo Antônio de Pádua, Rio de Janeiro, Brazil Pádua, Rio de Janeiro, Brazil Pádua, Rio de Janeiro, Brazil Pádua, Rio de Janeiro, Brazil Pádua, Rio de Janeiro, Brazil ABSTRACT -Objective: To define mini-mental state examination (MMSE) global scores, by age and education in elderly in Santo Antônio de Pádua, Rio de Janeiro,Brazil. Method: Elderly ≥ 65 years-old (n=341; m=109, f=232) responded to MMSE. Sample was divided by age and education: young old (65-84 years)/oldest old (>85 years), illiterates, low/medium schooling. MMSE scores were compared using t test of Student, MannWhitney and Tukey (p<0.05). Results: Young and oldest old's mean age were 73.13 ± 5.27; 88.00 ± 4.90, respectively. Young old MMSE score was 19.91 ± 5.35 and oldest old was 16.90 ± 4.96. There was a significant difference between the groups (p=0.01). Illiterate and educated elderly scored 17.08 ± 4.42 and 22.34 ± 4.94, respectively (p<0.0001). Illiterate and educated young old (age=73.61 ± 5.26; 72.67 ± 5.26) scored 17.29 ± 4.40 and 22.42 ± 4.98, respectively. MMSE shows significant difference between groups of young old (p<0.0001). MMSE of illiterate and educated oldest old (age=86.50 ± 1.09; 90.25 ± 7.34) were 14.33 ± 3.89 and 20.75 ± 3.85, respectively. Conclusion: Schooling and age influence on MMSE. These results do not compare with those of developed countries taking education as a variable.

OBJECTIVE: Mini-Mental State Examination cutoffs have been presented for schooling levels to screen cognitive impairment. However, items may behave differently with regards to education. The objective of this study was to examine the impact of education on MMSE subscales and items. METHOD: Community-dwelling participants aged 65 years or more (n = 990, females = 637, age = 74.1 years, range 65-108) were stratified as illiterate (n = 373), 1-8 (n = 540), 9-12 (n = 63), and more than 12 years of schooling (n = 14) and were screened with MMSE and Pfeffer Functional Activities Questionnaire. To make the Mini-Mental State Examination items comparable, each item was transformed into z scores. Multiple linear regression was used to estimate the effect of schooling on MMSE subs and items controlling for age, sex, and activities of daily life. RESULTS: Temporal and space orientation, attention/calculation, repetition, reading, writing, and drawing scores improved as education increased, but not memory registration, three step command, and naming. Reading and writing displayed the largest coefficients, whereas education exerted no influence on naming and three step command tasks. CONCLUSION: Education does not exert an important effect on naming, three step command, memory registration, and delayed recall. As memory is a key factor for diagnosing dementia, these items could be considered despite education.