The Mini-Mental-37 Test for Dementia Screening in the Spanish Population: An Analysis Using the Rasch Model

Abstract

Our aim was to analyze the psychometric properties of the Mini-Mental State Examination-37 using the Rasch Model (RM) in order to identify the cognitive domains that optimize detection of dementia in the Spanish population. All participants (n = 3955) were part of the NEDICES (Neurological Disorders in Central Spain) cohort study designed to detect dementia in persons aged 65 years and older. Clinical diagnosis of dementia (n = 178) was established by consensus of expert neurologists according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Results indicate that the items on the MMSE-37 have a good fit with the assumptions of the RM. None of the items on the MMSE-37 exhibits differential item functioning in relation to the groups. The items that assess orientation, attention, and language (repetition and comprehension) are those that best enable us to discriminate between the group with dementia and the group without dementia. The implications of the education and other sociodemographic characteristics of the population are discussed.

Psychometric Properties of the Montreal Cognitive Assessment (MoCA): An Analysis Using the Rasch Model

“…Few previous studies have examined the psychometric properties of the MoCA using the Rasch model. The Rasch model (Andrich, 1988;Wright & Mok, 2004) is a psychometric method that has been used for the analysis of neuropsychological assessment instruments (Conrad & Smith, 2004;Prieto et al, 2012;Prieto et al, 2010). The MoCA scores also demonstrated good sensitivity and specificity.…”

“…The absence of DIF tendency is a requisite for screening tests, essentially because we would not be able to compare the performance of different groups (healthy vs. clinical) if the MoCA did not have the same metric properties (Prieto et al, 2012).…”

“…The Rasch model (Andrich, 1988;Rasch, 1960;Wright & Mok, 2004) is a psychometric method appropriated for the analysis of neuropsychological assessment instruments with this purpose (Conrad & Smith, 2004;Prieto, Contador, Tapias-Merino, Mitchell & Bermejo-Pareja, 2012;Prieto, Delgado, Perea & Ladera, 2010). Indeed, the Rasch model plays an important role in modern psychometric studies, with relevant applications for the development and evaluation of measures for the quantification of cognitive impairment.…”

Rate of cognitive decline during the premotor phase of essential tremor

“…8,27,28,[33][34][35][36][37] The 37-MMSE included all of the standard MMSE items as well as 3 additional items: 1) an attention task, i.e., "say 1, 3, 5, 7, 9 backward"; 2) a visual order, i.e., a man raising his arms; and 3) a simple construction task, i.e., copying 2 overlapping circles. 8,27,28,[33][34][35][36][37] We grouped cognitive domain tasks into several subscores (orientation [0-10 points], memory [0-6 points], attention and calculation [0-10 points], language tasks [0-9 points], and construction/copying [0-2 points]). 8,27,28,[33][34][35][36][37] Final selection of participants.…”

“…8,27,28,[33][34][35][36][37] We grouped cognitive domain tasks into several subscores (orientation [0-10 points], memory [0-6 points], attention and calculation [0-10 points], language tasks [0-9 points], and construction/copying [0-2 points]). 8,27,28,[33][34][35][36][37] Final selection of participants. Of the 5,278 participants evaluated at baseline, we excluded 2,903 with incomplete data, dementia, or other neurodegenerative conditions (figure).…”