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Subtle cognitive impairment in elders with Mini-Mental State Examination scores within the 'normal' range
Timothy W Friedman1, Gregory W Yelland, Stephen R Robinson
1Blood-Brain Interactions Group, School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia.
International Journal of Geriatric Psychiatry
|June 1, 2011
Summary
Subtle cognitive impairment may be detected in older adults with Mini-Mental State Examination (MMSE) scores above the dementia cut-off. Lower MMSE scores (25-27) correlated with more errors on the Subtle Cognitive Impairment Test (SCIT).
Area of Science:
- Gerontology
- Neuropsychology
- Cognitive Science
Background:
- The Mini-Mental State Examination (MMSE) is a standard dementia screening tool.
- MMSE scores above the dementia cut-off (24-30) are often considered to have limited utility in older adults.
- The presence of pre-symptomatic cognitive impairment in this score range remains under-investigated.
Purpose of the Study:
- To investigate the utility of MMSE scores between 25-30 for detecting pre-symptomatic cognitive impairment.
- To determine if MMSE scores within the normal range can predict subtle cognitive deficits.
Main Methods:
- Ninety-six community-dwelling older adults (aged 62-89) with MMSE scores of 25-30 participated.
- Participants were administered the computer-based Subtle Cognitive Impairment Test (SCIT).
- Performance on the SCIT was analyzed in relation to MMSE scores and subtest performance.
Main Results:
- Individuals scoring 25-27 on the MMSE made significantly more errors on the SCIT compared to those scoring 30.
- MMSE subtest performance (language, attention, visual construction) correlated with SCIT performance.
- Systematic variations in SCIT performance were observed based on MMSE subtest errors.
Conclusions:
- MMSE scores within the 25-30 range can indicate subtle cognitive impairment in older adults.
- Specific patterns of MMSE errors may suggest different subtypes of cognitive impairment.
- These findings highlight the potential for early detection of cognitive decline in ostensibly normal older populations.
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