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 Volume 55, Number 11, December 12, 2000
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Neurology 2000;55:1609-1613
© 2000 American Academy of Neurology
Articles

Population norms for the MMSE in the very old

Estimates based on longitudinal data

C. Dufouil, PhD, D. Clayton, MSc, C. Brayne, MD, L. Y. Chi, PhD, T. R. Dening, MD, E. S. Paykel, MD, D. W. O’Connor, MD, A. Ahmed, MA, M. A. McGee, MSc and F. A. Huppert, PhD

From MRC Biostatistics Unit (Dr. Dufouil, D. Clayton, and M.A. McGee); Department of Community Medicine (Drs. Brayne and Chi, and A. Ahmed), Institute of Public Health; Psychiatric Services for the Elderly, Addenbrooke’s NHS Trust (Dr. Dening); Department of Psychiatry (Drs. Paykel and Huppert), University of Cambridge, UK; and Department of Psychological Medicine (Dr. O’Connor), Monash University, Australia. Dr. Dufouil was a visiting scientist from INSERM Unit 360 (Paris, France).

Address correspondence and reprint requests to Dr. C. Dufouil, INSERM Unit 360, Hôpital La Salpétrière, 75651 Paris Cédex 13, France; e-mail: dufouil{at}chups.jussieu.fr

OBJECTIVE: To report the percentile distribution of Mini-Mental State Examination (MMSE) scores in older people by age, sex, and education level, estimated from longitudinal data, after correcting for loss due to dropout.

METHODS: The Cambridge City over 75 Cohort is a population-based study of a cohort of 2106 subjects age 75 years and older at study entry followed up over 9 years. At each of the four waves, cognitive function was assessed using MMSE. Based on these data, the relationship between age and MMSE score was modeled. Percentile distributions by age, sex, and education level were provided using inverse probability weighting to correct for dropouts.

RESULTS: Performance on MMSE was related to age in men and women. In women, at age 75, MMSE score ranged from 21 (10th percentile) to 29 (90th percentile). At age 95, the range was 10 (10th percentile) to 27 (90th percentile). The upper end of MMSE distribution was slightly modified with age, whereas the lower end of the distribution was very sensitive to age effect. A similar pattern was observed in both sexes.

CONCLUSION: These findings provide norms for MMSE scores in subjects age 75 years and older from longitudinal population-based data. Such norms can be used as reference values to determine where an individual’s score lies in relation to his or her age, sex, and education level.




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