Ethnic and educational differences in cognitive test performance on mini-mental state examination in Asians.

Full Abstract

OBJECTIVE:
The objective of this study is to examine ethnic differences in Mini-Mental State Examination (MMSE) test performance in discriminating between demented and nondemented elderly Asians.

METHODS:
A nationally representative population sample (N = 1,092) of community-living elderly, comprising Chinese, Malays, and Indians in Singapore, was interviewed using MMSE, Geriatric Mental State, and demographic and health questionnaires.

RESULTS:
There were significant ethnic differences in mean MMSE scores among Chinese (26.2), Indians (25.0), and Malays (23.6), but only in noneducated subjects. No ethnic differences in MMSE were observed in higher educated subjects. The sample proportion of subjects with dementia was 4.2% in Chinese, 9.4% in Malays, and 8.8% in Indians. Overall, MMSE discriminated well between subjects with and without dementia (cutoff:
23/24, area under the curve:
95%, sensitivity:
97.5%, specificity:
75.6%). MMSE test performance was much better in higher educated subjects (higher specificity:
85.2%). Lower specificities were shown in less educated subjects (57.3%), and in Malays (62.8%), and especially in less educated Malays (35.3%) and Indians (50.0%). Significant differences in MMSE scores in less educated subjects persisted after adjusting for differences in sociodemographic, health, and behavioral variables

CONCLUSION:
Ethnic nonequivalence in MMSE test performance should be taken into account in dementia screening in Asians in less educated subjects. Known correlates of cognitive functioning did not sufficiently explain these differences.

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Author information

Author/s: Ng, Tze-Pin (TP); Niti, Matthew (M); Chiam, Peak-Chiang (PC); Kua, Ee-Heok (EH);

Affiliation: Gerontological Research Programme, National University of Singapore, Department of Psychological Medicine, National University Hospital, Singapore. pcmngtp(-atsign-)nus.edu.sg

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't

Journal: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry (Am J Geriatr Psychiatry), published in United States. (Language: eng)

Reference: 2007-Feb; vol 15 (issue 2) : pp 130-9

Dates: Created 2007/02/02; Completed 2007/05/02; Revised 2007/11/15;

PMID: 17272733, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Aged, 80 and over
Alzheimer Disease - diagnosis; ethnology; psychology
Asian Continental Ancestry Group - ethnology; psychology
Cross-Cultural Comparison
Diagnosis, Differential
Educational Status
Female
Humans

Humans
Male
Mass Screening
Mental Status Schedule - statistics & numerical data
Middle Aged
Psychometrics - statistics & numerical data
Risk Factors
Singapore - ethnology
Statistics as Topic

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