Prediction equation for the mini-mental state examination: influence of education, age, and sex
DOI:
https://doi.org/10.1590/1809-2950/17030126012019Keywords:
Cognition, Geriatric AssessmentAbstract
The mini-mental state examination (MMSE) is a screening test used worldwide for identifying changes in the scope of cognition. Studies have shown the influence of education, age and sex in the MMSE score. However, in Brazil, the studies consider only one factor to score it. The aim of this study was to establish a prediction equation for the MMSE. An exploratory cross-sectional study was developed and trained researchers examined participants at the community. The volunteers were evaluated by the MMSE and also by the Geriatric Depression Scale (GDS). The MMSE score was the dependent variable. Age, educational level, sex, and GDS score were the independent variables. Multivariate regression analysis was used to determine the model of best prediction value for MMSE scores. A total of 250 participants aged 20-99 years, without cognitive impairment, were assessed. The educational level, age, and sex explained 38% of the total variance of the MMSE score (p<0.0001) and resulted in the following equation: MMSE=23.350+0.265(years of schooling)- 0.042(age)+1.323(sex), in which female=1 and male=2. The MMSE scores can be better explained and predicted when educational level, age, and sex are considered. These results enhance the knowledge regarding the variables that influence the MMSE score, as well as provide a way to consider all of them in the test score, providing a better screening of these patients.
Downloads
References
Carvalho JAM, Garcia RA. The aging process in the Brazilian
population: a demographic approach. Cad Saúde Pública.
;19(3):725-33. doi: 10.1590/S0102-311X2003000300005
Lopes MA, Bottino CM. Prevalence of dementia in several
regions of the world: analysis of epidemiologic studies
from 1994 to 2000. Arq Neuropsiquiatr. 2002;60(1):61-9.
doi: 10.1590/S0004-282X2002000100012
Nilsson FM. Mini mental state examination (MMSE) – probably
one of the most cited papers in health science. Acta Psychiatr
Scand. 2007;116(2):156-7. doi: 10.1111/j.1600-0447.2007.01037.x
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”.
A practical method for grading the cognitive state of
patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
doi: 10.1016/0022-3956(75)90026-6
Lourenço RA, Veras RP, Ribeiro PCC. Test-retest reliability of the
Mini-Mental State Examination in an elderly population attended
in a primary health care setting. Rev Bras Geriatr Gerontol
[Internet]. 2008 [cited 2019 Jan 24];11(1):7-16. Available from:
https://www.redalyc.org/pdf/4038/403838777002.pdf
Brucki S. Mini-Exame do Estado Mental: influência da
escolaridade sobre os escores total e sub-itens. Rev Neuroci.
;4:15-20.
Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. The
Mini-Mental State Examination in an outpatient population:
influence of literacy. Arq Neuropsiquiatr. 1994;52(1):1-7.
doi: 10.1590/S0004-282X1994000100001
Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto
IH. Suggestions for utilization of the mini-mental state
examination in Brazil. Arq Neuropsiquiatr. 2003;61(3-B):777-81.
doi: 10.1590/S0004-282X2003000500014
Almeida O. The Mini-Mental State Examination and the diagnosis
of dementia in Brazil. Arq Neuropsiquiatr. 1998;56(3-B):605-12.
doi: 10.1590/S0004-282X1998000400014
Skoog J, Backman K, Ribbe M, Falk H, Gudmundsson P,
Thorvaldsson V, et al. A longitudinal study of the Mini-Mental
State Examination in late nonagenarians and its relationship
with dementia, mortality, and education. J Am Geriatr Soc.
;65(6):1296-300. doi: 10.1111/jgs.14871
Ylikoski R, Erkinjuntti T, Sulkava R, Juva K, Tilvis R, Valvanne J.
Correction for age, education and other demographic variables in
the use of the Mini Mental State Examination in Finland. Acta Neurol
Scand. 1992;85(6):391-6. doi: 10.1111/j.1600-0404.1992.tb06034.x
O’Connor D, Pollitt PA, Treasure FP, Brook CP, Reiss BB.
The influence of education, social class and sex on MiniMental State scores. Psychol Med. 1989;19(3):771-6.
doi: 10.1017/S0033291700024375
Argimon IIL, Lopes RMF, Terroso Lb, Farina M, Wendt G, Esteves
CS. Gender and education: a study through the mini-mental
state examination (MMSE) in elderly. Aletheia. 2012;38-39:153-61.
Dealberto MJ, Gagnon M, Barberger-Gateau P, Dartigues JF,
Alperovitch A. Influence of educational status on a screening
test for dementia, the Mini-Mental State Examination. Rev
Epidemiol Sante Publique. 1992;40(2):93-101.
Paradela EMP, Lourenço RA, Veras RP. Validation of geriatric
depression scale in a general outpatient clinic. Rev Saúde Pública.
;39(6):918-23. doi: 10.1590/S0034-89102005000600008
Portney LG, Watkins MP. Foundations of clinical research:
applications to practice. 3rd ed. Upper Saddle River (NJ):
Pearson/Prentice Hall; 2009. 892 p.
Culver B. How should the lower limit of the normal
range be defined? Respir Care. 2012;57(1):136-45.
doi: 10.4187/respcare.01427
Law S, Wolfson C. Validation of a French version of an informantbased questionnaire as a screening test for Alzheimer’s disease.
Br J Psychiatry. 1995;167(4):541-4. doi: 10.1192/bjp.167.4.541
Bravo G, Hébert R. Age- and education-specific reference
values for the Mini-Mental and modified Mini-Mental State Examinations derived from a non-demented elderly population.
Int J Geriatr Psychiatry. 1997;12(10):1008-18. doi: 10.1002/
(SICI)1099-1166(199710)12:10<1008::AID-GPS676>3.0.CO;2-A
Parente MP, Scherer LC, Zimmermann N, Fonseca RP. Evidence
of the role of education in brain organization. Rev Neuropsicol
Latinoam. 2009;1(1):72-80.
Farfel JM, Nitrini R, Suemoto CK, Grinberg LT, Ferretti RE,
Leite RE, et al. Very low levels of education and cognitive
reserve: a clinicopathologic study. Neurology. 2013;81(7):650-7.
doi: 10.1212/WNL.0b013e3182a08f1b
Aversi-Ferreira TA, Rodrigues HG, Paiva LR. Efeitos do
envelhecimento sobre o encéfalo. Rev Bras Ciênc Envelhec
Hum. 2008;5(2):46-64. doi: 10.5335/rbceh.2012.128
Hebert L, Scherr P, McCann J, Beckett L, Evans D. Is
the risk of developing Alzheimer’s disease greater for
women than for men? Am J Epidemiol. 2001;153(2):132-6.
doi: 10.1093/aje/153.2.132
Stella F, Gobbi S, Corazza DI, Costa JLR. Depressão no idoso:
diagnóstico, tratamento e benefícios da atividade física. Motriz.
;8(3):91-8.
Downloads
Published
Issue
Section
License
Copyright (c) 2019 Fisioterapia e Pesquisa
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.