Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination

Hensel, A.; Angermeyer, M. C.; Riedel-Heller, S. G.
December 2007
Journal of Neurology, Neurosurgery & Psychiatry;Dec2007, Vol. 78 Issue 12, p1298
Academic Journal
Background: In clinical and research settings, the Mini-Mental State Examination (MMSE) is commonly used to measure cognitive change over time. The interpretation of changes in MMSE is often difficult. They do not necessarily result from true clinical change. Their interpretation requires comparison with normative data for change. However, MMSE change norms are lacking for long intervals. Objective: To examine what is a reliable change in MMSE for long follow-up periods commonly used in clinic. To provide normative data for change. Methods: A sample of 119 cognitively normal individuals, aged 75 years and over, who participated in the Leipzig Longitudinal Study of the Aged (LEILA 75+). All participants were tested six times at 1.5 year intervals with the MMSE over a mean period of 7.1 years. Reliable change indices were computed for a common confidence interval (90%). Results: In repeated assessments with 1.5 year intervals, a change in MMSE of at least 2-4 points indicated a reliable change at the 90% confidence level. Conclusion: Small changes in MMSE can be interpreted only with great uncertainty. They have a reasonable probability of being caused by measurement error, regression to the mean or practice.


Related Articles

  • Cut-off Scores of a Brief Neuropsychological Battery (NBACE) for Spanish Individual Adults Older than 44 Years Old. Alegret, Montserrat; Espinosa, Ana; Valero, Sergi; Vinyes-Junqué, Georgina; Ruiz, Agustín; Hernández, Isabel; Rosende-Roca, Maitee; Mauleón, Ana; Becker, James T.; Tárraga, Lluís; Boada, Mercè // PLoS ONE;Oct2013, Vol. 8 Issue 10, p1 

    The neuropsychological battery used in Fundació ACE (NBACE) is a relatively brief, and easy to administer, test battery that was designed to detect cognitive impairment in the adulthood. The NBACE includes measures of cognitive information processing speed, orientation, attention, verbal...

  • Piracetam and learning impairment.  // Life Extension;Jan2003, Vol. 9 Issue 1, p77 

    Examines the effectiveness of piracetam in improving the cognition of elderly people suffering from dementia. Performance of a double-blind placebo controlled studies with piracetam; Improvement of cognitive impairment.

  • Cohort profile: The Dynamic Analyses to Optimize Ageing (DYNOPTA) project. Anstey, Kaarin J.; Byles, Julie E.; Luszcz, Mary A.; Mitchell, Paul; Steel, David; Booth, Heather; Browning, Colette; Butterworth, Peter; Cumming, Robert G.; Healy, Judith; Windsor, Timothy D.; Ross, Lesley; Bartsch, Lauren; Burns, Richard A.; Kiely, Kim; Birrell, Carole L.; Broe, Gerald A.; Shaw, Jonathan; Kendig, Hal // International Journal of Epidemiology;Feb2010, Vol. 39 Issue 1, p44 

    The article discusses the Dynamic Analyses to Optimize Ageing (DYNOPTA) project aimed at profiling the aging generation of Australia to help the government develop policies regarding healthy aging in the country. The project focuses on dementia and cognition, mental health, sensory function and...

  • Dementia risk is revealed by test.  // GP: General Practitioner;8/22/2008, p3 

    The article reports on the U.S. medical study which suggests that elderly patients with inconsistent scores across different neuropsychological tests are at increased risk of dementia. It shows that the erratic performance on cognitive tests may be a more useful marker of incipient dementia than...

  • A randomized controlled trial investigating the effect of Pycnogenol and Bacopa CDRI08 herbal medicines on cognitive, cardiovascular, and biochemical functioning in cognitively healthy elderly people: the Australian Research Council Longevity Intervention (ARCLI) study protocol (ANZCTR12611000487910)  // Nutrition Journal;2012, Vol. 11, p11 

    The article discusses the findings of a randomized controlled trial related to the effect of pycnogenol and bacopa CDRI08 herbal medicines on cognitive, cardiovascular, and biochemical functioning in cognitively healthy elderly people. The findings show that pycnogenol prolongs the lifetime of...

  • The Impact of Nutrition on Cognition in the Elderly. Kathleen Van Dyk // Neurochemical Research;Apr2007, Vol. 32 Issue 4/5, p893 

    Abstract  The possibility that nutritional manipulation may protect against cognitive decline and dementia is an inviting prospect. However data supporting a beneficial effect of a particular dietary pattern is limited. Although studies have demonstrated a health benefit to dietary plans...

  • Daily folic acid supplementation for 3 years improved cognitive function in older persons. Durga, J.; Van Boxtel, M.P.; Schouten, E. G. // Evidence Based Medicine;Jun2007, Vol. 12 Issue 3, p83 

    The article answers a question on whether daily folic acid supplementation for three years improve cognitive function in older persons. Research results indicate that folic acid group improved more than the placebo group for global cognitive function and memory and decline less for information...

  • Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. Ancelin, Marie L.; Artero, Sylvaine; Portet, Florence; Dupuy, Anne-Marie; Touchon, Jacques; Ritchie, Karen // BMJ: British Medical Journal (International Edition);2/25/2006, Vol. 332 Issue 7539, p455 

    Objective To assess the potential of anticholinergic drugs as a cause of non-degenerative mild cognitive impairment in elderly people. Design Longitudinal cohort study. Setting 63 randomly selected general practices in the Montpellier region of southern France. Participants 372 people aged > 60...

  • The LIFE Cognition Study: design and baseline characteristics. Sink, Kaycee M.; Espeland, Mark A.; Rushing, Julia; Castro, Cynthia M.; Church, Timothy S.; Cohen, Ronald; Gill, Thomas M.; Henkin, Leora; Jennings, Janine M.; Kerwin, Diana R.; Manini, Todd M.; Myers, Valerie; Pahor, Marco; Reid, Kieran F.; Woolard, Nancy; Rapp, Stephen R.; Williamson, Jeff D. // Clinical Interventions in Aging;2014, Vol. 9, p1425 

    Observational studies have shown beneficial relationships between exercise and cognitive function. Some clinical trials have also demonstrated improvements in cognitive function in response to moderate-high intensity aerobic exercise; however, these have been limited by relatively small sample...


Read the Article


Sign out of this library

Other Topics