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Interactive influences of demographics on the Mini-Mental State Examination (MMSE) and the demographics-adjusted norms for MMSE in elderly Koreans

  • Jeong Lan Kim (a1), Joon Hyuk Park (a2), Bong Jo Kim (a3), Moon Doo Kim (a2), Shin-Kyum Kim (a4), Yeon Kyung Chi (a5), Tae Hui Kim (a5), Seok Woo Moon (a6), Moon Ho Park (a7), Jae Nam Bae (a8), Jong Inn Woo (a9) (a10), Seung-Ho Ryu (a11), Jong Chul Yoon (a12), Nam-Jin Lee (a13), Dong Young Lee (a9) (a10), Dong Woo Lee (a14), Seok Bum Lee (a15), Jung Jae Lee (a16), Chang-Uk Lee (a17), Sung Man Chang (a16), Ji Won Han (a5), Jin Hyeong Jhoo (a18), Changsu Han (a19), Maeng Je Cho (a9) (a10) and Ki Woong Kim (a5) (a10)...

Abstract

Background: The influences of demographics, culture, language, and environmental changes on Mini-Mental State Examination (MMSE) scores are considerable.

Methods: Using a sample of 7452 healthy, community-dwelling elderly Koreans, aged 55 to 94 years, who participated in the four ongoing geriatric cohorts in Korea, we investigated demographic influences on MMSE scores and derived normative data for this population. Geropsychiatrists strictly excluded subjects with cognitive disorders according to the protocol of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K) Clinical Assessment Battery (CERAD-K-C).

Results: Education (standardized β = 0.463), age (standardized β = −0.303), and gender (standardized β = −0.057) had significant effects on MMSE scores (p < 0.001). The score of MMSE increase 0.379 point per 1-year education, decrease 0.188 per 1-year older, and decrease 0.491 in women compared to men. Education explained 30.4% of the scores’ total variance, which was much larger than the variances explained by age (8.4%) or gender (0.3%). Accordingly, we present normative data for the MMSE stratified by education (0, 1–3, 4–6, 7–9, 10–12, and ≥ 13 years), age (60–69, 70–79, and 80–89 years), and gender.

Conclusions: We provide contemporary education-, age-, and gender-stratified norms for the MMSE, derived from a large, community-dwelling elderly Korean population sample, which could be useful in evaluating individual MMSE scores.

Copyright

Corresponding author

Correspondence should be addressed to: Ki Woong Kim, Department of Neuropsychiatry, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu Seongnam-si, Gyeonggi-do 463-707, Korea. Phone. +82 31 787 7439; Fax +82 31 787 4058. Email: kwkimmd@snu.ac.kr.

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