Age‐Normative MMSE Data for Older Persons Aged 85 to 93 in a Longitudinal Swedish Cohort

Abstract

Background/Objectives Normative Mini‐mental state examination (MMSE) reference values in elderly are scarce. Therefore, the aim is to present normative MMSE values for 85–93 year olds. Design A longitudinal age cohort study. Setting A population study of the residents in the municipality of Linköping, Sweden. Participants Residents (n = 650) born in 1922 during the course of 2007. In total, 374 individuals participated and were tested with MMSE at age 85, 280 of these were willing and able to also participate at age 86, 107 at age 90 and 51 at age 93. Measurements MMSE, from 0–30, with lower scores denoting more impaired cognition. Results Median MMSE values for the total population over the ages 85, 86, 90 and 93 years was 28 for all ages investigated. The 25th percentile values were 26, 26, 26 and 27, respectively. For a “brain healthy” sub‐group median values were 28, 29, 28, and 28. The 25th percentile values were 27, 28, 26 and 27, respectively. Comparisons for age‐effects showed no differences when all individuals for each age group were compared. When only the individuals reaching 93 years of age (n = 50) were analyzed, there was a significant lowering of MMSE in that age group. Conclusion The literature is variable and in clinical practice a low (24) MMSE cut off is often used for possible cognitive impairment in old age. The present data indicate that MMSE 26 is a reasonable cut off for possible cognitive decline in older persons up to the age of 93. J Am Geriatr Soc 67:534–538, 2019.

Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression

“…The SMMSE is overly weighted towards tests of orientation (one-third of its points), which is best able to identify established dementia [28]. Further, while a cut-off of <24/30 is widely applied for the SMMSE, recent studies suggest that higher cut-offs between 26 [37] and 29 [13], closer to that found here, are more accurate and produce a better balance between sensitivity and specificity. As with its’ original validation study [8,28], this analysis confirms the Q mci screen is more accurate overall and that its logical memory subtest is its most accurate for separating MCI from normal controls.…”

Effects of aging on emotion recognition from dynamic multimodal expressions and vocalizations

“…Both young and old participants completed the Mini-Mental State Examination (MMSE 47 ) before taking part in the emotion recognition tasks. A cutoff score of 26 (adapted for Swedish populations 48 ) suggests potential cognitive impairment. All participants scored higher than this cutoff and no participants were excluded based on this criterion.…”

Geriatric Aspects of Frail Nursing Home Residents : A Swedish cohort study

“…Scores range from 0 to 30, with a score <24 generally used to raise a suspicion of cognitive impairment [115]. However, very recently a higher MMSE cut-off at ≤26 has been suggested for older persons up to the age of 93 [116]. Consequently, an MMSE cut off of <24 may be a conservative MMSE value to indicate cognitive impairment in these populations.…”

“…MMSE scores range from 0 to 30, with a score below 24 generally used to raise a suspicion of cognitive impairment [115]. Even though the 24 cut-off level has been challenged [116], it can be regarded as a conservative cut-off level with few false positive cases. However, MMSE is a screening test.…”