Abstract
Objectives
This study published in two companion papers assesses properties of the Mini-Mental
State Examination (MMSE) with the purpose of improving the efficiencies of the methods
of screening for cognitive impairment and dementia.
Study Design and Setting
An item analysis by conventional and mixed Rasch models was used to explore empirically
derived cognitive dimensions of the MMSE, to assess item bias, and to construct diagnostic
cut-points. The scores of 1,189 elderly residents were analyzed.
Results
Two dimensions of cognitive function, which are statistically and conceptually different
from those obtained in previous studies, were derived. The corresponding sum scales
were (1) age-correlated MMSE scale (A-MMSE scale: orientation to time, attention/calculation,
naming, repetition, and three-stage command) and (2) non–age-correlated MMSE scale
(B-MMSE scale: orientation to place, registration, recall, reading, and copying).
The “writing” item was not included due to differential effects of age and sex. The
analysis also showed that the study sample consisted of two cognitively different
groups of elderly.
Conclusions
The findings indicate that a two-scale solution is a stable and statistically supported
framework for interpreting data obtained by means of the MMSE. Supplementary analyses
are presented in the companion paper to explore the performance of this item response
theory calibration as a screening test for dementia.
Keywords
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Article info
Publication history
Published online: August 12, 2006
Accepted:
June 26,
2006
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
