What is a significant score change on the mini‐mental state examination?

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Abstract
The distribution of change scores of the Mini‐Mental State Examination (MMSE) was assessed in healthy aged subjects after an interval of 1 year. As part of the Amsterdam Study of the Elderly, which is a community survey on ageing and cognitive decline (N = 4051; age range 65–84), a subsample of subjects (N = 247) was studied twice. Participants with dementia, other psychiatric disorders or physical disease which might interfere with cognitive testing were excluded. Test‐retest reliability was 0.55 in this group. The distribution of change scores ranged from −9 to +5. From this result the following clinical rule‐of‐thumb was derived. In an individual patient, and in the absence of other indications of a dementing process, a deterioration in MMSE score must be greater than five points after 1 year to be suspect for a genuine cognitive decline.