The Mini Mental State Examination: Review of cutoff points adjusted for schooling in a large Southern Brazilian sample

Abstract

The increase in life expectancy can influence the prevalence of dementias in the population. Instruments that evaluate cognitive functions such as the Mini Mental State Examination (MMSE) are necessary for the investigation of dementia. The supposition that patient score on the MMSE can be influenced by academic level points to the need for establishing cut-off values that take into account educational level. The aim of this study was to review MMSE cut-off values adjusted for schooling in a large southern Brazilian sample.MethodDemographic data and MMSE scores of 968 subjects, of which 162 were dementia patients and 806 healthy participants, were analyzed. The sample was grouped according to education. The cut-off values were established by ROC Curve analysis.ResultsThe total sample mean age was 70.6±7.3 years, and the mean years of education was 7.2±5.3. The cut-off score of 23 points (sensitivity=86%, specificity=83%) was observed as the optimal level to detect dementia on the MMSE instrument for the overall sample. Regarding level of schooling, the cut-off values were: 21 for the illiterate group (sensitivity=93%, specificity=82%), 22 for the low education group (sensitivity=87%, specificity=82%), 23 for the middle education group (sensitivity=86%, specificity=87%) and 24 for the high education group (sensitivity=81%, specificity=87%).ConclusionsThe cut-off values revealed by this analysis, and adjusted for level of schooling, can improve the clinical evaluation of cognitive deficits.

Normative data of the Brazilian elderly in Logical Memory subtest of WMS-R

“…The elderly from FHSP were randomly selected from two neighborhoods in Porto Alegre and they were assessed by neurologists, psychiatrics, psychologists, and nutritionists. Initially, 460 elders were included in the study, and the exclusion criteria were: 1. scores suggestive of cognitive decline in the Mini Mental State Examination (adapted by Bertolucci, Brucki, Campacci, & Juliano, 1994), according to the cutoff points suggested by Kochhann, Varela, Lisboa, and Chaves (2010) that are suitable for the elderly population in south Brazil (21 points for illiterate, 22 for 1-5 years in formal education, 23 for 6-11, and 24 for 12 or more years); 2. not completing the evaluation battery; and 3. self-reported psychiatric or neurologic diagnosis.…”

“…MMSE: a screening test that provides temporo-spatial orientation, registration, attention/calculation, recall, and language measures, whose total score ranges between 0 and 30 points. The cutoff points suggested by Kochhann et al (2010) are suitable for the elderly in southern Brazil and present sensitivity between 81% and 93% and specificity between 82% and 87%; 4. LM subtest (immediate recall) of WMS-R (Wechsler, 1987); 5. a visual distractor task; 6.…”

Patients with autosomal dominant spinocerebellar ataxia have more risk of falls, important balance impairment, and decreased ability to function

“…Patients with clinical and molecular-proven SCA types 1, 2, 3, and 6 were included in the study. Wheelchair patients and those with major cognitive deficit (mini-mental state examination [MMSE] score <24 or <19 if illiterate) [6][7][8] were excluded. SCA7 patients were excluded due to visual impairment.…”

Fatores associados à satisfação com serviços odontológicos entre idosos

“…Of those who agreed to take part, the study was composed of those who reported using dental care and who showed no defi ciency in cognitive capacity, tested using the Mini Mental test version validated for Brazil, with total scores adjusted for the level of Education of the testee. 8 The household interviews and examinations were conducted by trained interviewers and examiners. The data collection was carried out by 24 dental-surgeons who participated in special training (Kappa inter/intra examiners and intra-class correlation coeffi cient ≥ 0.60).…”