Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Dec;78(12):1298-303.
doi: 10.1136/jnnp.2006.109074. Epub 2007 Apr 18.

Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination

A Hensel  1 , M C Angermeyer, S G Riedel-Heller
Affiliations

Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination

A Hensel et al. J Neurol Neurosurg Psychiatry. 2007 Dec.

Abstract

Background: In clinical and research settings, the Mini-Mental State Examination (MMSE) is commonly used to measure cognitive change over time. The interpretation of changes in MMSE is often difficult. They do not necessarily result from true clinical change. Their interpretation requires comparison with normative data for change. However, MMSE change norms are lacking for long intervals.

Objective: To examine what is a reliable change in MMSE for long follow-up periods commonly used in clinic. To provide normative data for change.

Methods: A sample of 119 cognitively normal individuals, aged 75 years and over, who participated in the Leipzig Longitudinal Study of the Aged (LEILA 75+). All participants were tested six times at 1.5 year intervals with the MMSE over a mean period of 7.1 years. Reliable change indices were computed for a common confidence interval (90%).

Results: In repeated assessments with 1.5 year intervals, a change in MMSE of at least 2-4 points indicated a reliable change at the 90% confidence level.

Conclusion: Small changes in MMSE can be interpreted only with great uncertainty. They have a reasonable probability of being caused by measurement error, regression to the mean or practice.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None.

References

    1. Folstein M F, Folstein S E, McHugh P R. “Mini‐mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 197512189–198. - PubMed
    1. Tombaugh T N. Test–retest reliable coefficients and 5‐year change scores for the MMSE and 3MS. Arch Clin Neuropsychol 200520485–503. - PubMed
    1. Schmand B, Lindeboom J, Launer L.et al What is a significant score change on the Mini‐Mental State examination? Int J Geriatr Psychiatry 199510411–414.
    1. Ivnik R J, Smith G E, Lucas J A.et al Testing normal older people three or four times at 1‐ to 2‐year intervals: defining normal variance. Neuropsychology 199913121–127. - PubMed
    1. Park H L, O'Connell J E, Thomson R G. A systematic review of cognitive decline in the general elderly population. Int J Geriatr Psychiatry 2003181121–1134. - PubMed

Publication types