Comparing Mini‐Mental Status Exam baseline data of cognitively normal individuals who declined to Alzheimer’s disease versus cognitively normal non‐decliners in the SIU Longitudinal cognitive aging study

Background The Mini‐Mental Status Exam (MMSE) is one of the most commonly used cognitive screening measures for diagnosing cognitive impairment in older adults. In the present study, we examined whether or not there were baseline differences in MMSE scores between cognitively normal individuals who developed Alzheimer’s disease over time (decliners) versus individuals who did not decline over time (non‐decliners). Method We included 67 participants who were administered the MMSE during a baseline assessment. All participants were enrolled in the SIU Longitudinal Cognitive Aging Study (SIU LCAS) as controls who were free of cognitive impairment at their baseline visits. Participants were divided into two groups (decliners versus non‐decliners). There were 25 participants in the decliner group and 39 participants in the non‐decliner group. Average age of decliners was 70.84, while average age of non‐decliners was 71.67. Average education of decliners was 15.76 years, while average education of non‐decliners was 16.49 years. The ratio of females to males was 4:1 among decliners and 1.6:1 among non‐decliners. A two‐sample t‐test was used to examine differences between the two groups with respect to their baseline MMSE scores. Result The decliner group (mean age = 70.8) was significantly younger than the non‐decliner group (mean age = 71.7). There were no significant differences between the two groups for education or gender distribution. 11 decliners had autopsy confirmed AD, while 14 decliners had AD diagnosis without autopsy. There were 5 individuals in the non‐decliner group with no evidence of AD pathology on autopsy. The decliner group had significantly lower baseline MMSE scores compared to the non‐decliner group (p < 0.05). MMSE scores for decliners compared to non‐decliners using WORLD backwards was 28.96 versus 29.44, respectively, and was 28.32 versus 28.85, respectively, when using serial 7’s. Conclusion The results of the present study indicate that there are subtle differences in baseline MMSE scores (approximately 0.5 points) in older adults who decline to AD compared to older adults who remained cognitively normal. More studies with larger sample sizes, including more participants with brain autopsy, are needed to confirm these findings.