Age- and education-specific reference values for the Mini-Mental and Modified Mini-Mental State Examinations derived from a non-demented elderly population

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Abstract
Main objective. To report age‐ and education‐specific reference values for the Mini‐Mental State Examination (MMSE) and Modified Mini‐Mental State (3MS) Examination. Design. Cross‐sectional study. Setting. Community and institutional settings in five regions across Canada. Participants. 7754 subjects aged 65 and over randomly chosen to take part in the Canadian Study of Health and Aging. Subjects classified as cognitively impaired or demented following a clinical and neuropsychological examination were excluded. Measurements. Total scores on the MMSE and 3MS, and the degree to which they are influenced by the age, sex, education, mother tongue and living environment of the subject. Results. Reference values on the two tests are reported through various descriptive statistics for five age groups and four education levels. These values decrease with age and increase with years of schooling. Test scores are also influenced by the subject's sex and mother tongue, albeit to a lesser extent. These observations led to the development of predictive equations of the performance to be expected from a ‘normal’ elderly subject, given his/her sociodemographic characteristics. Conclusion. The use of the reference values and related predictive equations will allow the clinician to interpret a patient's performance on two widely used cognitive tests, in light of the value expected from a group of ‘normal’ subjects with the same sociodemographic profile. © 1997 John Wiley & Sons, Ltd.