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Clinical Manifestations.

Mo-Kyung Sin1, Richard M Allman2, Charles Faselis3

  • 1Seattle University, Seattle, WA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Even a slight decrease in Mini-Mental Status Examination (MMSE) scores within the normal range is linked to a higher risk of Alzheimer's disease and related dementias (ADRD) in older adults. This finding suggests MMSE can help identify individuals for targeted ADRD prevention.

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Area of Science:

  • Gerontology
  • Neurology
  • Public Health

Background:

  • Impaired cognitive function is a known risk factor for Alzheimer's disease and related dementias (ADRD).
  • The association between normal-range Mini-Mental Status Examination (MMSE) scores (27-30) and ADRD risk in older adults is not well understood.

Purpose of the Study:

  • To investigate the relationship between normal cognitive function, as measured by MMSE scores of 27-30, and the risk of developing ADRD in community-dwelling older adults.
  • To determine if a decline in MMSE score within the normal range is an independent predictor of ADRD.

Main Methods:

  • Analysis of data from 4433 community-dwelling older adults (≥65 years) with normal baseline cognitive function (MMSE 27-30) from the Cardiovascular Health Study (CHS).
  • Comparison of baseline characteristics and incident ADRD across MMSE scores of 30, 29, 28, and 27.
  • Use of multivariable Cox proportional hazards models to assess the association between MMSE scores (29, 28, 27) and incident ADRD, with MMSE 30 as the reference, adjusting for 27 covariates.

Main Results:

  • Participants with lower normal MMSE scores (27-29) were older and had higher scores for activities of daily living (ADL) impairment compared to those with MMSE 30 (p < 0.001).
  • Adjusted hazard ratios for incident ADRD increased incrementally with declining MMSE scores: 1.42 for MMSE 29, 1.71 for MMSE 28, and 1.92 for MMSE 27, compared to MMSE 30 (p < 0.001 for all).
  • Age, BMI, diabetes, depression, and smoking were also significant predictors of ADRD.

Conclusions:

  • A decline in MMSE score from 30, even within the normal range, is significantly associated with an increased and independent risk of developing ADRD in older adults.
  • The MMSE can be a valuable tool for risk-stratifying older adults with normal cognition, enabling targeted ADRD prevention strategies.