Cognitive Screening of Nursing Home Residents: Factor Structures of the Mini‐Mental State Examination

Abstract

The 2-factor solution shows that, notwithstanding previous claims to the contrary, the MMSE can make stable and independent distinctions between psychomotor and perceptual-organizational processes. However, this solution is statistically and conceptually limited and, therefore, of limited clinical and scientific relevance. The 4-factor solution of the MMSE maps well onto commonly recognized dimensions of neurocognitive ability. It offers a stable, intuitively sound, and statistically supported framework for clinical differentiation of cognitive screening data into independent clinical dimensions of neurocognitive functioning. Thus, it offers clinicians and researchers a 4-dimensional framework for interpreting data obtained by means of the MMSE. Studies with other populations of cognitively impaired and intact elderly are recommended to validate and extend the present findings.

Mini-Mental Status Examination: Mixed Rasch model item analysis derived two different cognitive dimensions of the MMSE

“…Other factor analyses [9e15] have yielded conceptually conflicting factor structures (mostly two-and three-factor solutions), and have not been able to show that the internal structure is consistent with that proposed by Folstein et al [2]. Two other previous studies carried out among nursing home residents and geriatric stroke patients [10,12] interpreted MMSE factors into ''intuitively sound and clinically informative neurocognitive dimensions.' ' We agree with Jones and Gallo [16] that heterogeneous samples across [11,14,17] and within [13] studies may have contributed to the development of conceptually unstable MMSE structures in previous studies.…”

Consequences from use of reminiscence - a randomised intervention study in ten Danish nursing homes

“…Assessment of resident cognition, behaviour and quality of life is not straightforward, however, and may be affected by background factors, e.g. educational level, physical health state, level of dementia [40,41]. In the current context the instruments showed high completion rates, good test-retest reliability and expected correlations between instruments (data not shown).…”

Construct Validity of the 15-Item Geriatric Depression Scale in Older Medical Inpatients

“…18 None of the previous studies assessed the construct validity of sfGDS on an unselected hospitalized geriatric population. Furthermore, the size of previously studied 20 The complex psychological status of older patients experiencing both an acute illness and the hospital stay likely limits the possibility of a reliable screening of depression. 21 Although we studied our patients immediately before discharge, it is unlikely that this limitation was completely overcome.…”