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Cut-off scores in MMSE: a moving target?

J Morgado¹, C S Rocha, C Maruta

¹Laboratory of Language Research, Faculty of Medicine of Lisbon, Institute of Molecular Medicine, Hospital de Santa Maria, Lisboa, Portugal.

European Journal of Neurology

|January 7, 2010

Summary

Cognitive performance scores have improved over time, particularly for individuals with lower literacy. This lifelong secular improvement suggests changes in cognitive assessment benchmarks may impact diagnoses like mild cognitive impairment.

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Area of Science:

Gerontology
Cognitive Science
Psychometrics

Background:

Cognitive test performance is influenced by language, culture, and education.
Secular increases in IQ test scores suggest a potential 'epoch' effect on cognition.
This 'epoch' effect may extend into later life, influencing cognitive performance.

Purpose of the Study:

To investigate the hypothesis of a lifelong secular improvement in cognitive performance.
To compare cognitive test results between two cohorts evaluated 20 years apart.

Main Methods:

Compared Mini-Mental State Examination (MMSE) scores of individuals aged 50+ from 1988 and 2008.
Analyzed performance differences between cohorts, controlling for age and literacy.
Utilized regression analysis to determine factors influencing MMSE score variance.

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Main Results:

Higher MMSE scores were observed in the 2008 cohort compared to the 1988 cohort.
The difference was significant in subgroups with lower literacy.
Literacy, epoch (time of assessment), and age significantly explained score variance.

Conclusions:

Results support the existence of a lifelong secular improvement in cognitive performance.
Cognitive assessment cut-off values may need adjustment over time.
Changes in cognitive benchmarks have potential clinical implications for diagnosing cognitive disorders.