Ethnic and Educational Differences in Cognitive Test Performance on Mini-Mental State Examination in Asians

Ng, Tze‐Pin; Niti, Mathew; Chiam, Peak-Chiang; Kua, Ee Heok

doi:10.1097/01.jgp.0000235710.17450.9a

Cited by 179 publications

(145 citation statements)

References 51 publications

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“…Briefly, participants were screened using the Mini-Mental State Examination (MMSE) [15,16]. Participants with an MMSE score below 27 or MMSE decline of ≥1 point per year were further assessed using the Clinical Dementia Rating (CDR) scale [17] and a standardized battery of detailed neurocognitive tests (see Ng et al [14]), additional blood tests, clinical examination, and brain magnetic resonance imaging.…”

Section: Methodsmentioning

confidence: 99%

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

Heywood

Gao

Nyunt

et al. 2017

Dement Geriatr Cogn Disord

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Aim: To investigate the associations between hearing loss and prevalent and incident mild cognitive impairment (MCI), dementia and MCI or dementia (all cases). Methods: Cross-sectional and longitudinal analyses of baseline and follow-up data were performed in a population-based cohort. The baseline sample of 2,599 adults aged ≥55 included 1,515 cognitively normal subjects who were followed up to 8 years. Hearing loss at baseline was determined by the whispered voice test, and MCI and dementia by Mini-Mental State Examination screening, Clinical Dementia Rating scale, neurocognitive tests, MRI, and panel consensus diagnosis. Results: Hearing impairment was associated with increased prevalence of dementia (odds ratio = 3.63, 95% confidence interval [CI] 1.16-11.4, p = 0.027) but not MCI alone or all cases of MCI or dementia, adjusted for sex, age, ethnicity, education, central obesity, hypertension, diabetes, dyslipidemia, smoking, alcohol, leisure time activity, cardiac diseases, and depressive symptoms. Among participants who were cognitively normal at baseline, those with hearing impairment were more likely to develop MCI or dementia (hazard ratio [HR] = 2.30, 95% CI 1.08-4.92, p = 0.032). Hearing loss was associated with elevated but statistically nonsignificant estimates of adjusted HR (1.85, 95% CI 0.78-4.40) for incident MCI alone. Conclusions: Hearing loss is independently associated with prevalent dementia and incident MCI or dementia.

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Section: Methodsmentioning

confidence: 99%

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

Heywood

Gao

Nyunt

et al. 2017

Dement Geriatr Cogn Disord

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“…Total scores range from 0 to 30, with higher scores denoting better cognitive function. We used the Chinese version of the MMSE which had been previously validated in an independent study [27] to have high sensitivity (95.5%) and specificity (83.5%) in detecting dementia in Chinese older adults, using a cutoff of 23/24. Respondents with MMSE scores of 23 or less were classified as cognitively impaired.…”

Section: Cognitive Status At Baseline and Follow-upmentioning

confidence: 99%

Orthostatic Hypotension, Hypotension and Cognitive Status: Early Comorbid Markers of Primary Dementia?

Yap¹,

Niti²,

Yap³

et al. 2008

Dement Geriatr Cogn Disord

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Objective: Few studies have explored the relationship between orthostatic hypotension (OH) and cognition. The aim of this study was to examine the association of OH with cognitive impairment and decline in a cohort of Chinese elderly, and its effect modification by blood pressure (BP) status at baseline. Method: Among 2,321 community-living older adults, free of cardiovascular disease and stroke, baseline BP measurements were used to determine the presence of OH and categorize participants as hypotensives, normotensives or hypertensives. The Mini-Mental State Examination (MMSE) was used to assess cognitive impairment (MMSE score <24). Cognitive decline (decrease in MMSE score by ≧1) was assessed from 1 to 2 years of follow-up for 1,347 participants without baseline cognitive impairment. Results: Mean age of the subjects was 65.5 years and 381 (16.6%) showed OH. OH was not associated with cognitive impairment overall. However, among hypotensives, OH increased the odds of cognitive impairment (OR = 4.1, 95% CI = 1.11–15.1), while hypertensives with OH showed reduced odds of cognitive impairment (OR = 0.48, 95% CI = 0.26–0.90). Among cognitively intact participants, OH was not associated with cognitive decline overall or in BP subgroups. Conclusion: The increased risk of cognitive impairment in hypotensives with OH suggests that hypotension with OH may be an early comorbid marker of a primary incipient dementia.

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“…Local translated versions of the instrument with a cutoff of 23/24 (97.5% sensitivity and 75.6% specificity; AUC: 95%) that was used to determine cognitive impairment have been validated for local use in Singaporean older adults (30).…”

Section: Other Variablesmentioning

confidence: 99%

Homocysteine, folate, vitamin B-12, and physical function in older adults: cross-sectional findings from the Singapore Longitudinal Ageing Study

Ng¹,

Aung²,

Feng³

et al. 2012

The American Journal of Clinical Nutrition

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Background: There is a paucity of studies, as well as inconsistent findings, on the associations of homocysteine, folate, and vitamin B-12 with physical function and decline in older persons. Objective: We investigated the independent associations of homocysteine, folate, and vitamin B-12 with gait and balance performance and Instrumental Activities of Daily Living (IADL) in community-living older persons. Design: We performed cross-sectional analyses on baseline data of 796 respondents in the Singapore Longitudinal Ageing Study who had laboratory measurements of fasting homocysteine folate and vitamin B-12 and completed Performance Oriented Mobility Assessment (POMA) of gait and balance and self-reports of IADLs. Results: In multivariate analyses in which sex, age, education, housing type, comorbidities, hospitalization, depression and global cognitive scores, BMI, creatinine, arthritis and hip fracture, serum albumin and hemoglobin, and physical activities were controlled for, we showed that homocysteine, independently of folate and vitamin B-12, showed significant negative associations with POMA balance (P = 0.02), POMA gait scores (P , 0.01), and IADL (P , 0.01). Serum folate showed a significant positive association only with POMA balance scores (P , 0.045). No significant independent associations for vitamin B-12 were observed. Conclusions: The independent association of elevated homocysteine and low folate, but not vitamin B-12, on physical and functional decline was supported in this study. Interventional studies of the physical functional effects of folate and vitamin B-12 status in different populations are needed.Am J Clin Nutr 2012;96: 1362-8.

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Ethnic and Educational Differences in Cognitive Test Performance on Mini-Mental State Examination in Asians

Cited by 179 publications

References 51 publications

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

Orthostatic Hypotension, Hypotension and Cognitive Status: Early Comorbid Markers of Primary Dementia?

Homocysteine, folate, vitamin B-12, and physical function in older adults: cross-sectional findings from the Singapore Longitudinal Ageing Study

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