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The reliability of assigning individuals to cognitive states using the Mini Mental-State Examination: a population-based prospective cohort study

Marioni, Riccardo E., Chatfield, Mark D., Brayne, Carol and Matthews, Fiona E. (2011). The reliability of assigning individuals to cognitive states using the Mini Mental-State Examination: a population-based prospective cohort study. BMC Medical Research Methodology,11(1):127-132.

Document type: Journal Article
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Title The reliability of assigning individuals to cognitive states using the Mini Mental-State Examination: a population-based prospective cohort study
Author Marioni, Riccardo E.
Chatfield, Mark D.
Brayne, Carol
Matthews, Fiona E.
Journal Name BMC Medical Research Methodology
Publication Date 2011
Volume Number 11
Issue Number 1
ISSN 1471-2288   (check CDU catalogue open catalogue search in new window)
Start Page 127
End Page 132
Total Pages 6
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
Abstract Background
Previous investigations of test re-test reliability of the Mini-Mental State Examination (MMSE) have used correlations and statistics such as Cronbach's α to assess consistency. In practice, the MMSE is usually used to group individuals into cognitive states. The reliability of this grouping (state based approach) has not been fully explored.

Methods
MMSE data were collected on a subset of 2,275 older participants (≥ 65 years) from the population-based Medical Research Council Cognitive Function and Ageing Study. Two measurements taken approximately two months apart were used to investigate three state-based categorisations. Descriptive statistics were used to determine how many people remained in the same cognitive group or went up or down groups. Weighted logistic regression was used to identify predictive characteristics of those who moved group.

Results
The proportion of people who remained in the same MMSE group at screen and follow-up assessment ranged from 58% to 78%. The proportion of individuals who went up one or more groups was roughly equal to the proportion that went down one or more groups; most of the change occurred when measurements were close to the cut-points. There was no consistently significant predictor for changing cognitive group.

Conclusion
A state-based approach to analysing the reliability of the MMSE provided similar results to correlation analyses. State-based models of cognitive change or individual trajectory models using raw scores need multiple waves to help overcome natural variation in MMSE scores and to help identify true cognitive change.
Keywords MMSE
reliability
test-retest
ageing
elderly
DOI http://dx.doi.org/10.1186/1471-2288-11-127   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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Created: Mon, 12 Nov 2012, 15:01:31 CST by Teresa Haendel