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Mapping modified Mini-Mental State Examination (MMSE) scores to dementia stages in a multi-ethnic Asian population

Published online by Cambridge University Press:  18 July 2018

Xin Ying Chua
Affiliation:
Frailty Programme, Geriatric Education and Research Institute, Singapore, Singapore
Robin Wai Munn Choo
Affiliation:
Frailty Programme, Geriatric Education and Research Institute, Singapore, Singapore
Ngoc Huong Lien Ha
Affiliation:
Frailty Programme, Geriatric Education and Research Institute, Singapore, Singapore
Chin Yee Cheong
Affiliation:
Geriatric Center, Khoo Teck Puat Hospital, Alexandra Health System, Singapore, Singapore
Shiou Liang Wee
Affiliation:
Frailty Programme, Geriatric Education and Research Institute, Singapore, Singapore Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
Philip Lin Kiat Yap
Affiliation:
Frailty Programme, Geriatric Education and Research Institute, Singapore, Singapore Geriatric Center, Khoo Teck Puat Hospital, Alexandra Health System, Singapore, Singapore
Corresponding

Abstract

The MMSE is used to screen for cognitive impairment and estimate dementia severity. In clinical settings, conventional cut-off scores have been used to distinguish between dementia stages. However, these scores have not been validated for different populations. This study maps scores from the modified version of the MMSE to dementia stages delineated by the Diagnostic and Statistical Manual of Mental Disorders-3rd revised edition (DSM-III-R), the Clinical Dementia Rating (CDR) and Functional Assessment Staging Test (FAST). We used cross-sectional data from a tertiary hospital memory clinic. Subjects were stratified into “primary education and below” (PE) or “secondary education and above” (SE). Receiving operating characteristic (ROC) analyses and Cohen's κ were performed to determine MMSE cut-off scores for dementia stages. Our derived cut-off scores were lower compared to the conventional scores. Scores also differed between subjects of different education levels. MMSE cut-off scores were 19, 15, and 9 for CDR stages 1, 2, and 3 respectively in PE subjects, and 23, 17, and 10 for SE subjects. Cut-off scores were comparable for staging by DSM-III-R Criteria and FAST. There is a need for locally derived stage-specific MMSE cut-off scores for the Asian population adjusted for education.

Type
Brief Report
Copyright
Copyright © International Psychogeriatric Association 2018 

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Mapping modified Mini-Mental State Examination (MMSE) scores to dementia stages in a multi-ethnic Asian population
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