49
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The Mini Mental State Examination: Review of cutoff points adjusted for schooling in a large Southern Brazilian sample Translated title: Mini Exame do Estado Mental: revisão de pontos de corte ajustados para a escolaridade em uma grande amostra do sul do Brasil

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          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.

          Method

          Demographic 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.

          Results

          The 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%).

          Conclusions

          The cut-off values revealed by this analysis, and adjusted for level of schooling, can improve the clinical evaluation of cognitive deficits.

          Translated abstract

          A elevação da expectativa de vida pode influenciar na prevalência das demências na população. Instrumentos que avaliem as funções cognitivas, como o Mini Exame do Estado Mental (MEEM), são necessários para a investigação de demência. A suposição de que o resultado do MEEM de um paciente pode ser influenciado pelo nível de escolaridade demonstra a necessidade do estabelecimento de pontos de corte que levem em consideração a escolaridade. O objetivo deste estudo foi revisar os pontos de corte do MEEM ajustados para a escolaridade em uma grande amostra do sul do Brasil.

          Método

          Dados demográficos e escores do MEEM de 968 indivíduos, 162 pacientes com demência e 806 participantes saudáveis foram analisados. A amostra foi agrupada de acordo com a educação. Para estabelecer os pontos de corte foi utilizada a Curva ROC.

          Resultados

          A média de idade da amostra total foi 70,6±7,3 e a média de anos de estudo foi 7,2±5,3. O ponto de corte 23 (sensibilidade=86%), (especificidade=83%) foi o ponto que melhor detectou demência na amostra total. Considerando o nível de escolaridade, os pontos de corte foram: 21 no grupo de analfabetos (sensibilidade=93%, especificidade=82%), 22 no grupo de baixa escolaridade (sensibilidade=87%, especificidade=82%), 23 no grupo de média escolaridade (sensibilidade=86%, especificidade=87%) e 24 no grupo de alta escolaridade (sensibilidade=81%, especificidade=87%).

          Conclusões

          Os pontos de corte, quando se considera a escolaridade, podem aperfeiçoar a avaliação clínica dos déficits cognitivos.

          Related collections

          Most cited references71

          • Record: found
          • Abstract: found
          • Article: not found

          [Suggestions for utilization of the mini-mental state examination in Brazil].

          Mini-metal state examination (MMSE) is a screening test to detect cognitive impairment. The objectives of the present study are to describe some adaptations for use of MMSE in Brazil and to propose rules for its uniform application. We evaluated 433 healthy subjects using the MMSE and verified the possible influence of demographic variables on total scores. Educational level was the main factor that influenced performance, demonstrated by ANOVA: F(4,425) = 100.45, p<0.0001. The median values for educational groups were: 20 for illiterates; 25 for 1 to 4 yrs; 26.5 for 5 to 8 yrs; 28 for 9 to 11 yrs and 29 for higher levels. The MMSE is an excellent screening instrument and definitive rules are necessary for comparison purposes.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            [The Mini-Mental State Examination in a general population: impact of educational status].

            To assess the influence of age and education on cognitive performance in our population, 530 adults were interviewed using the MMSE (Mini-Mental Status Examination). Education level, classified as illiterate, elementary and middle ( 8 years), was a significant predictor of performance (p or = 65 years). The reference cut-off values were taken from the fifth percent lowest score for each group: illiterate, 13; elementary and middle, 18; and high, 26. When compared to 94 patients with cognitive impairment, our cut-off values achieved high sensitivity (82.4% for illiterates; 75.6% for elementary and middle; 80% for high) and specificity (97.5% for illiterate; 96.6% for elementary and middle; 95.6% for high educational level). Education-specific reference values for the MMSE are necessary in interpreting individual test results in populations of low educational level, in order to reduce the false positive results.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Limits of the 'Mini-Mental State' as a screening test for dementia and delirium among hospital patients.

              With a psychiatrist's standardized clinical diagnosis as the criterion, the 'Mini-Mental State' Examination (MMSE) was 87% sensitive and 82% specific in detecting dementia and delirium among hospital patients on a general medical ward. The false positive ratio was 39% and the false negative ratio was 5%. All false positives had less than 9 years of education; many were 60 years of age or older. Performance on specific MMSE items was related to education or age. These findings confirm the MMSE's value as a screen instrument for dementia and delirium when later, more intensive diagnostic enquiry is possible; they reinforce earlier suggestions that the MMSE alone cannot yield a diagnosis for these conditions.
                Bookmark

                Author and article information

                Journal
                Dement Neuropsychol
                Dement Neuropsychol
                dn
                Dementia & Neuropsychologia
                Associação de Neurologia Cognitiva e do Comportamento
                1980-5764
                Jan-Mar 2010
                Jan-Mar 2010
                : 4
                : 1
                : 35-41
                Affiliations
                [1 ]Medical Sciences Post-Graduate Course, UFRGS School of Medicine.
                [2 ]Dementia Clinic, Neurology Service, Hospital de Clínicas de Porto Alegre.
                [3 ]Internal Psychology Department, UNISINOS School of Psychology.
                [4 ]Internal Medicine Department, UFRGS School of Medicine.
                Author notes
                Márcia L.F. Chaves – Rua Ramiro Barcelos 2350 / sala 2040 - 90035-091 Porto Alegre RS - Brazil. Email: mchaves@ 123456hcpa.ufrgs.br
                Article
                10.1590/S1980-57642010DN40100006
                5619528
                29213658
                7f205c19-9086-4990-90fb-eab357817390

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 October 2009
                : 27 January 2010
                Categories
                Original Articles

                mini mental state examination,cognition,cognitive assessment,educational attainment,cutoffs

                Comments

                Comment on this article

                scite_
                0
                0
                0
                0
                Smart Citations
                0
                0
                0
                0
                Citing PublicationsSupportingMentioningContrasting
                View Citations

                See how this article has been cited at scite.ai

                scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

                Similar content59

                Cited by98

                Most referenced authors1,183