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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

Published online by Cambridge University Press:  14 December 2011

Jeong Lan Kim
Affiliation:
Department of Psychiatry, Chungnam National University Hospital, Daejeon, Korea
Joon Hyuk Park
Affiliation:
Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
Bong Jo Kim
Affiliation:
Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Korea
Moon Doo Kim
Affiliation:
Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
Shin-Kyum Kim
Affiliation:
Department of Neuropsychiatry, Gwangju Inkwang Dementia Hospital, Gwangju, Korea
Yeon Kyung Chi
Affiliation:
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
Tae Hui Kim
Affiliation:
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
Seok Woo Moon
Affiliation:
Department of Psychiatry, Konkuk University Chungju Hospital, Chungju, Korea
Moon Ho Park
Affiliation:
Department of Neurology, Korea University Ansan Hospital, Ansan, Korea
Jae Nam Bae
Affiliation:
Department of Psychiatry, Inha University Hospital, Incheon, Korea
Jong Inn Woo
Affiliation:
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
Seung-Ho Ryu
Affiliation:
Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea
Jong Chul Yoon
Affiliation:
Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Korea
Nam-Jin Lee
Affiliation:
Department of Psychiatry, Jeonju City Welfare Hospital for the Elderly, Jeonju, Korea
Dong Young Lee
Affiliation:
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
Dong Woo Lee
Affiliation:
Department of Neuropsychiatry, Inje University Snaggye Paik Hospital, Seoul, Korea
Seok Bum Lee
Affiliation:
Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
Jung Jae Lee
Affiliation:
Department of Psychiatry, Kyungbook National University Hospital, Daegu, Korea
Chang-Uk Lee
Affiliation:
Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
Sung Man Chang
Affiliation:
Department of Psychiatry, Kyungbook National University Hospital, Daegu, Korea
Ji Won Han
Affiliation:
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
Jin Hyeong Jhoo
Affiliation:
Department of Neuropsychiatry, Kangwon National University Hospital, Chooncheon, Korea
Changsu Han
Affiliation:
Department of Psychiatry, Korea University Ansan Hospital, Ansan, Korea
Maeng Je Cho
Affiliation:
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
Ki Woong Kim*
Affiliation:
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
*
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.

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.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

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