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      Call for Papers: Sex and Gender in Neurodegenerative Diseases

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      About Neurodegenerative Diseases: 3.0 Impact Factor I 4.3 CiteScore I 0.695 Scimago Journal & Country Rank (SJR)

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      Validation Study of the Mini-Mental State Examination in a Malay-Speaking Elderly Population in Malaysia

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          Abstract

          Background/Aims: In view of the differing sensitivity and specificity of the Mini-Mental State Examination (MMSE) in the non-English-speaking populations, we conducted the first validation study of the Malay version (M-MMSE) in Malaysia among 300 subjects (from the community and outpatient clinics). Methods: Three versions were used: M-MMSE-7 (serial 7), M-MMSE-3 (serial 3) and M-MMSE-S (spell ‘dunia’ backwards). Dementia was assessed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV. The optimal cutoff scores were obtained from the receiver operating characteristics curves. Results: Seventy-three patients (24.3%) had dementia and 227 (75.7%) were controls. Three hundred patients completed the M-MMSE-7, 160 the M-MMSE-3 and 145 the M-MMSE-S. All 3 versions were valid and reliable in the diagnosis of dementia. The optimal cutoff scores varied with each version and gender. In the control group, significant gender differences were observed in the patients with the lowest educational status. Increasing educational levels significantly improved the M-MMSE performance in both genders. Conclusion: All 3 versions of the M-MMSE are valid and reliable as a screening tool for dementia in the Malaysian population, but at different cutoff scores. In those with the lowest educational background, gender-adjusted cutoff scores should be applied.

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          Simplifying detection of cognitive impairment: comparison of the Mini-Cog and Mini-Mental State Examination in a multiethnic sample.

          Ping Tu, Mary C Lessig, David Scanlan … (2005)
          To compare detection of cognitive impairment using the Mini-Cog and Mini-Mental State Examination (MMSE) and to identify sociodemographic variables that influence detection in an ethnoculturally diverse sample. Cross-sectional. A registry of the University of Washington Alzheimer's Disease Research Center Satellite. A heterogeneous community sample (n=371) of predominantly ethnic minority elderly assessed using a standardized research protocol, 231 of whom met criteria for dementia or mild cognitive impairment (MCI). Demographic data, a standardized research protocol for cognitive assessment and dementia diagnosis, MMSE, and Mini-Cog. Both screens effectively detected cognitive impairment, the Mini-Cog slightly better than the MMSE (P<.01). Overall accuracy of classification was 83% for the Mini-Cog and 81% for the MMSE. The Mini-Cog was superior in recognizing patients with Alzheimer-type dementias (P=.05). Low education negatively affected detection using the MMSE (P<.001), whereas education did not affect the Mini-Cog, and low literacy minimally affected it. The Mini-Cog detects clinically significant cognitive impairment as well as or better than the MMSE in multiethnic elderly individuals, is easier to administer to non-English speakers, and is less biased by low education and literacy.
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            Ethnic and educational differences in cognitive test performance on mini-mental state examination in Asians.

            Matthew Niti, Ee Kua, Peak Chiang Chiam … (2007)
            The objective of this study is to examine ethnic differences in Mini-Mental State Examination (MMSE) test performance in discriminating between demented and nondemented elderly Asians. A nationally representative population sample (N = 1,092) of community-living elderly, comprising Chinese, Malays, and Indians in Singapore, was interviewed using MMSE, Geriatric Mental State, and demographic and health questionnaires. There were significant ethnic differences in mean MMSE scores among Chinese (26.2), Indians (25.0), and Malays (23.6), but only in noneducated subjects. No ethnic differences in MMSE were observed in higher educated subjects. The sample proportion of subjects with dementia was 4.2% in Chinese, 9.4% in Malays, and 8.8% in Indians. Overall, MMSE discriminated well between subjects with and without dementia (cutoff: 23/24, area under the curve: 95%, sensitivity: 97.5%, specificity: 75.6%). MMSE test performance was much better in higher educated subjects (higher specificity: 85.2%). Lower specificities were shown in less educated subjects (57.3%), and in Malays (62.8%), and especially in less educated Malays (35.3%) and Indians (50.0%). Significant differences in MMSE scores in less educated subjects persisted after adjusting for differences in sociodemographic, health, and behavioral variables Ethnic nonequivalence in MMSE test performance should be taken into account in dementia screening in Asians in less educated subjects. Known correlates of cognitive functioning did not sufficiently explain these differences.
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              Sensitivity and specificity of the Mini-Mental State Examination in a Spanish-speaking population.

              F Ostrosky, Alfredo Ardila, G. Monserratt Lopez-Ayon (1999)
              The Mini-Mental State Examination (MMSE; Folstein, Folstein, & McHugh, 1975) was given to a total of 430 normal participants divided into 3 age ranges (16-50, 51-65, and 66-89) and 4 educational ranges (0, 1-4, 5-9, and > or = 10 years). The educational level effect was notoriously stronger than the age effect. Normal illiterate participants obtained scores that would correspond to severe cognitive alterations (M = 17.67); low education participants (1-4 years) would be classified with moderate cognitive alterations (M = 20.61). Sensitivity and specificity of the MMSE were established. Low sensitivity and specificity were found for both the participants with 0 and 1 to 4 years of schooling, 50% and 72.73%, respectively. In participants with more than 5 years of schooling, the specificity (86.36%) and sensitivity (86.36%) indexes were higher. We concluded that the MMSE is an instrument with little diagnostic utility among participants with a low level of education.
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                Author and article information

                Journal
                Journal ID (publisher-id): DEM
                Journal ID (nlm-ta): Dement Geriatr Cogn Disord
                Journal ID (doi): 10.1159/issn.1420-8008
                Title: Dementia and Geriatric Cognitive Disorders
                Publisher: S. Karger AG
                ISSN (Print): 1420-8008
                ISSN (Electronic): 1421-9824
                Publication date Subscription-year: 2009
                Publication date (Print): March 2009
                Publication date (Electronic): 25 February 2009
                Volume: 27
                Issue: 3
                Pages: 247-253
                Affiliations
                Departments of aMedicine and bPsychiatry, Faculty of Medicine, University Kebangsaan Malaysia Medical Center, and cDepartment of Neurology, Faculty of Medicine, University Malaya Medical Center, Kuala Lumpur, and dDepartment of Biology, University Putra Malaysia, Selangor, Malaysia
                Article
                Publisher ID: 203888 Other ID: Dement Geriatr Cogn Disord 2009;27:247–253
                DOI: 10.1159/000203888
                PubMed ID: 19246909
                SO-VID: 6ca097f7-67eb-4a15-ba46-9b445c52ba7f
                Copyright © © 2009 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date accepted : 31 October 2008
                Page count
                Tables: 5, References: 19, Pages: 7
                Categories
                Subject: Original Research Article

                ScienceOpen disciplines: Geriatric medicine,Neurology,Cardiovascular Medicine,Neurosciences,Clinical Psychology & Psychiatry,Public health
                Keywords: Malay,Cutoff scores,Dementia,Malaysia,Mini-Mental State Examination
                Data availability:
                ScienceOpen disciplines: Geriatric medicine, Neurology, Cardiovascular Medicine, Neurosciences, Clinical Psychology & Psychiatry, Public health
                Keywords: Malay, Cutoff scores, Dementia, Malaysia, Mini-Mental State Examination

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