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

TLDR

The study aimed to evaluate how age and education affect MMSE scores and to establish education‑specific reference cut‑offs to reduce false positives in low‑education populations. MMSE scores from 530 adults were used to derive cut‑offs based on the 5th percentile of each education group (illiterate = 13, elementary/middle = 18, high = 26). Education level was a significant predictor of MMSE performance, age had no effect, and the proposed cut‑offs achieved high sensitivity (≈80%) and specificity (≈96%) when compared to 94 cognitively impaired patients.

Abstract

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) and high (> 8 years), was a significant predictor of performance (p < 0.0001). Nevertheless, the total scores were not significantly different among the age-groups, young (< or = 50 years), middle age 51 to 64 years) and elderly (> 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.