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Observational Study
. 2025 Mar 17;37(1):88.
doi: 10.1007/s40520-025-02946-4.

Cognitive function in generally healthy adults age 70 years and older in the 5-country DO-HEALTH study: MMSE and MoCA scores by sex, education and country

Melanie Kistler-Fischbacher  1   2 , Ghazala Gohar  1   3 , Caroline de Godoi Rezende Costa Molino  1   2 , Katharina Geiling  1   2 , Tatjana Meyer-Heim  4 , Reto W Kressig  5 , E John Orav  6 , Bruno Vellas  7 , Sophie Guyonnet  7 , José A P da Sliva  8   9 , René Rizzoli  10 , Gabriele Armbrecht  11 , Elisabeth Steinhagen-Thiessen  12 , Andreas Egli  1   2 , Heike A Bischoff-Ferrari  13   14
Affiliations
Observational Study

Cognitive function in generally healthy adults age 70 years and older in the 5-country DO-HEALTH study: MMSE and MoCA scores by sex, education and country

Melanie Kistler-Fischbacher et al. Aging Clin Exp Res. .

Abstract

Background: Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are validated and frequently used screening tools for cognitive function.

Aims: To present MMSE and MoCA scores by sex, age and education among community-dwelling older adults.

Methods: This is a post-hoc observational analysis using data from the DO-HEALTH trial, which included generally healthy adults (≥ 70 years) from Switzerland, Germany, Austria, France, and Portugal who scored at least 24 points on the MMSE at baseline. We present MMSE and MoCA scores overall and by country, sex, age (70-74 years, ≥ 75 years), education (≤ and > median education years).

Results: 2151 DO-HEALTH participants (mean age 74.9 years, 57% aged 70-74 years, 62% women) were included. The median (IQR) years of education was 12 (10-15), median MMSE score was 29 (28-30) and median MoCA score was 26 (23-28) points. In subgroups by sex, age, and education, the median MMSE score remained 29 for all subgroups, except for participants with shorter education (≤ 12 years) and higher age (≥ 75), who scored 28 points. For MoCA, the median score in subgroups ranged from 24 to 27 points. Participants with shorter education (≤ 12 years) and higher age (≥ 75) had lowest scores (men 24, women 25 points).

Conclusions: We provide MMSE and MoCA scores for generally healthy, community-dwelling older adults from Switzerland, Germany, Austria, France and Portugal. The median MMSE and MoCA scores differed with age and education, and - less consistently - with sex.

Trial registration: International Trials Registry (clinicaltrials.gov; registration ID: NCT01745263), registered December 2012.

Keywords: Cognitive function; Mini mental state examination; Montreal cognitive assessment; Observational study.

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Conflict of interest statement

Declarations. Competing interests: HAB-F reports as the PI of the DO-HEALTH trial, grants from the European Commission (Grant Agreement No. 278588), from the University of Zurich, from NESTEC, from PFIZER Consumer Healthcare, from Streuli Pharma, plus non-financial support from DSM Nutritional Products and from Roche Diagnostics. Furthermore, HAB-F reports speaker fees from Wild, Pfizer, Vifor, Mylan, Roche Diagnostics, and independent and investigator initiated grants from Pfizer and from Vifor, outside the submitted work. BV declares participation in the following advisory boards: Biogen, Alzheon, Norvo Nordisk, Lilly, Eisai France and International, Roche, TauX and Cerecin. JAPD declares honoraria from Amgen and Fresenius-Kabi and support meetings/travels from MedacAP. TM-H declares speaker fees from OM pharma. MK-F, GG, CG, KG, RWK, EJO, SG, GA, RR, GA, ES-T, AE, declare no conflict of interest.

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