Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination
Background:In clinical and research settings, the Mini-Mental State Examination (MMSE) is commonly used to measure cognitive change over time. The interpretation of changes in MMSE is often difficult. They do not necessarily result from true clinical change. Their interpretation requires comparison...
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| Veröffentlicht in: | Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2007-12, Vol.78 (12), p.1298-1303 |
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| container_title | Journal of neurology, neurosurgery and psychiatry |
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| creator | Hensel, A Angermeyer, M C Riedel-Heller, S G |
| description | Background:In clinical and research settings, the Mini-Mental State Examination (MMSE) is commonly used to measure cognitive change over time. The interpretation of changes in MMSE is often difficult. They do not necessarily result from true clinical change. Their interpretation requires comparison with normative data for change. However, MMSE change norms are lacking for long intervals.Objective:To examine what is a reliable change in MMSE for long follow-up periods commonly used in clinic. To provide normative data for change.Methods:A sample of 119 cognitively normal individuals, aged 75 years and over, who participated in the Leipzig Longitudinal Study of the Aged (LEILA 75+). All participants were tested six times at 1.5 year intervals with the MMSE over a mean period of 7.1 years. Reliable change indices were computed for a common confidence interval (90%).Results:In repeated assessments with 1.5 year intervals, a change in MMSE of at least 2–4 points indicated a reliable change at the 90% confidence level.Conclusion:Small changes in MMSE can be interpreted only with great uncertainty. They have a reasonable probability of being caused by measurement error, regression to the mean or practice. |
| doi_str_mv | 10.1136/jnnp.2006.109074 |
| format | Article |
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The interpretation of changes in MMSE is often difficult. They do not necessarily result from true clinical change. Their interpretation requires comparison with normative data for change. However, MMSE change norms are lacking for long intervals.Objective:To examine what is a reliable change in MMSE for long follow-up periods commonly used in clinic. To provide normative data for change.Methods:A sample of 119 cognitively normal individuals, aged 75 years and over, who participated in the Leipzig Longitudinal Study of the Aged (LEILA 75+). All participants were tested six times at 1.5 year intervals with the MMSE over a mean period of 7.1 years. Reliable change indices were computed for a common confidence interval (90%).Results:In repeated assessments with 1.5 year intervals, a change in MMSE of at least 2–4 points indicated a reliable change at the 90% confidence level.Conclusion:Small changes in MMSE can be interpreted only with great uncertainty. They have a reasonable probability of being caused by measurement error, regression to the mean or practice.</description><identifier>ISSN: 0022-3050</identifier><identifier>EISSN: 1468-330X</identifier><identifier>DOI: 10.1136/jnnp.2006.109074</identifier><identifier>PMID: 17442763</identifier><identifier>CODEN: JNNPAU</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Activities of daily living ; Aged ; Aging ; Biological and medical sciences ; Cognition Disorders - diagnosis ; Cognitive ability ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Dementia ; Disease Progression ; Female ; Humans ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Longitudinal studies ; Male ; Medical sciences ; Neurology ; Neuropsychological Tests ; Neuropsychology ; Norms ; Older people ; Population-based studies ; Reproducibility of Results ; Severity of Illness Index ; Traumas. Diseases due to physical agents</subject><ispartof>Journal of neurology, neurosurgery and psychiatry, 2007-12, Vol.78 (12), p.1298-1303</ispartof><rights>2007 BMJ Publishing Group Ltd</rights><rights>2008 INIST-CNRS</rights><rights>Copyright: 2007 2007 BMJ Publishing Group Ltd</rights><rights>Copyright © 2007 BMJ Publishing Group Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b557t-df943f59295cf5046f89cc4e014a79b9aee74c8fab9b7457fa52b7b57110c69d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jnnp.bmj.com/content/78/12/1298.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jnnp.bmj.com/content/78/12/1298.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,723,776,780,881,3183,23550,27901,27902,53766,53768,77343,77374</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19859004$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17442763$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hensel, A</creatorcontrib><creatorcontrib>Angermeyer, M C</creatorcontrib><creatorcontrib>Riedel-Heller, S G</creatorcontrib><title>Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination</title><title>Journal of neurology, neurosurgery and psychiatry</title><addtitle>J Neurol Neurosurg Psychiatry</addtitle><description>Background:In clinical and research settings, the Mini-Mental State Examination (MMSE) is commonly used to measure cognitive change over time. The interpretation of changes in MMSE is often difficult. They do not necessarily result from true clinical change. Their interpretation requires comparison with normative data for change. However, MMSE change norms are lacking for long intervals.Objective:To examine what is a reliable change in MMSE for long follow-up periods commonly used in clinic. To provide normative data for change.Methods:A sample of 119 cognitively normal individuals, aged 75 years and over, who participated in the Leipzig Longitudinal Study of the Aged (LEILA 75+). All participants were tested six times at 1.5 year intervals with the MMSE over a mean period of 7.1 years. Reliable change indices were computed for a common confidence interval (90%).Results:In repeated assessments with 1.5 year intervals, a change in MMSE of at least 2–4 points indicated a reliable change at the 90% confidence level.Conclusion:Small changes in MMSE can be interpreted only with great uncertainty. They have a reasonable probability of being caused by measurement error, regression to the mean or practice.</description><subject>Activities of daily living</subject><subject>Aged</subject><subject>Aging</subject><subject>Biological and medical sciences</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognitive ability</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Dementia</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Humans</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Longitudinal studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neurology</subject><subject>Neuropsychological Tests</subject><subject>Neuropsychology</subject><subject>Norms</subject><subject>Older people</subject><subject>Population-based studies</subject><subject>Reproducibility of Results</subject><subject>Severity of Illness Index</subject><subject>Traumas. Diseases due to physical agents</subject><issn>0022-3050</issn><issn>1468-330X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkc1v00AQxS0EoqFw54RWQnBBDrNfXm8PSCgtBakphwLithqv18kGZx127ar89zhy1BYuncsc5jdPb-Zl2UsKc0p58X4Twm7OAIo5BQ1KPMpmVBRlzjn8fJzNABjLOUg4yp6ltIF9lfppdkSVEEwVfJb5pcM0RB9WxHar4Ht_7YhdY1g54gPp2tpFgvXQ9umERNd6rNp7QO2tS6TpIunXjix98PnShR5bctVj78jZDW59wN534Xn2pME2uReHfpx9_3T2bfE5v_h6_mXx8SKvpFR9Xjda8EZqpqVtJIiiKbW1wgEVqHSl0TklbNlgpSslpGpQskpVUlEKttA1P84-TLq7odq62o52IrZmF_0W4x_ToTf_ToJfm1V3bRhoKXUxCrw9CMTu9-BSb7Y-Wde2GFw3JFOUko-P1A-CDARVVMMIvv4P3HRDDOMXDFUlZYIzzUYKJsrGLqXomlvPFMw-brOP2-zjNlPc48qr-7feLRzyHYE3BwCTxbaJGKxPd5wupQbYC-UT51Pvbm7nGH-ZQnElzeWPhblSp-dwyi8NHfl3E19tNw_b_AtoxdEO</recordid><startdate>20071201</startdate><enddate>20071201</enddate><creator>Hensel, A</creator><creator>Angermeyer, M C</creator><creator>Riedel-Heller, S G</creator><general>BMJ Publishing Group Ltd</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7TK</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20071201</creationdate><title>Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination</title><author>Hensel, A ; Angermeyer, M C ; Riedel-Heller, S G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b557t-df943f59295cf5046f89cc4e014a79b9aee74c8fab9b7457fa52b7b57110c69d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Activities of daily living</topic><topic>Aged</topic><topic>Aging</topic><topic>Biological and medical sciences</topic><topic>Cognition Disorders - diagnosis</topic><topic>Cognitive ability</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Dementia</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Humans</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Longitudinal studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neurology</topic><topic>Neuropsychological Tests</topic><topic>Neuropsychology</topic><topic>Norms</topic><topic>Older people</topic><topic>Population-based studies</topic><topic>Reproducibility of Results</topic><topic>Severity of Illness Index</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hensel, A</creatorcontrib><creatorcontrib>Angermeyer, M C</creatorcontrib><creatorcontrib>Riedel-Heller, S G</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hensel, A</au><au>Angermeyer, M C</au><au>Riedel-Heller, S G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination</atitle><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle><addtitle>J Neurol Neurosurg Psychiatry</addtitle><date>2007-12-01</date><risdate>2007</risdate><volume>78</volume><issue>12</issue><spage>1298</spage><epage>1303</epage><pages>1298-1303</pages><issn>0022-3050</issn><eissn>1468-330X</eissn><coden>JNNPAU</coden><abstract>Background:In clinical and research settings, the Mini-Mental State Examination (MMSE) is commonly used to measure cognitive change over time. The interpretation of changes in MMSE is often difficult. They do not necessarily result from true clinical change. Their interpretation requires comparison with normative data for change. However, MMSE change norms are lacking for long intervals.Objective:To examine what is a reliable change in MMSE for long follow-up periods commonly used in clinic. To provide normative data for change.Methods:A sample of 119 cognitively normal individuals, aged 75 years and over, who participated in the Leipzig Longitudinal Study of the Aged (LEILA 75+). All participants were tested six times at 1.5 year intervals with the MMSE over a mean period of 7.1 years. Reliable change indices were computed for a common confidence interval (90%).Results:In repeated assessments with 1.5 year intervals, a change in MMSE of at least 2–4 points indicated a reliable change at the 90% confidence level.Conclusion:Small changes in MMSE can be interpreted only with great uncertainty. They have a reasonable probability of being caused by measurement error, regression to the mean or practice.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>17442763</pmid><doi>10.1136/jnnp.2006.109074</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Activities of daily living Aged Aging Biological and medical sciences Cognition Disorders - diagnosis Cognitive ability Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Dementia Disease Progression Female Humans Injuries of the nervous system and the skull. Diseases due to physical agents Longitudinal studies Male Medical sciences Neurology Neuropsychological Tests Neuropsychology Norms Older people Population-based studies Reproducibility of Results Severity of Illness Index Traumas. Diseases due to physical agents |
| title | Measuring cognitive change in older adults: reliable change indices for the Mini-Mental State Examination |
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