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Item and scale differential functioning of the Mini-Mental State Exam assessed using the Differential Item and Test
Leo S Morales1, Claudia Flowers, Peter Gutierrez
1Department of Health Services and Division of General Internal Medicine and Health Services Research at UCLA, Los Angeles, CA 90095-1772, USA. lsmorales@mednet.ucla.edu
Medical Care
|October 25, 2006
Summary
The Mini-Mental State Examination (MMSE) shows no differential functioning at the scale level between English and Spanish versions. However, individual item analysis may be misleading for cognitive impairment assessments.
Area of Science:
- Gerontology
- Psychometrics
- Neuroscience
Background:
- The Mini-Mental State Examination (MMSE) is a widely used tool for assessing cognitive impairment.
- Evaluating the psychometric properties of translated assessment tools is crucial for cross-cultural research.
Purpose of the Study:
- To apply the Differential Item and Test Functioning (DFIT) method to compare English and Spanish versions of the MMSE.
- To investigate potential biases in MMSE items across different language groups.
Main Methods:
- The study utilized data from 1578 older adults in North Manhattan, with 665 completing the MMSE in Spanish.
- Item response theory and the DFIT framework were employed to estimate parameters and assess differential item functioning (DIF) and differential test functioning (DTF).
Main Results:
- Nine specific MMSE items demonstrated differential item functioning (DIF) between English and Spanish versions.
- Despite DIF in individual items, the MMSE did not exhibit differential functioning at the overall scale level.
Conclusions:
- Overall MMSE scale scores are comparable between English and Spanish speaking respondents.
- Caution is advised when interpreting individual MMSE item responses due to observed DIF.
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