AGE AND EDUCATION CORRECTION OF MINI-MENTAL-STATE-EXAMINATION FOR ENGLISH AND SPANISH-SPEAKING ELDERLY

Previous research has shown that the Mini-Mental State Examination (MM S) is biased as a measure of cognitive impairment in minority and low- education patients. The purpose of this study was to (1) develop a sta tistical correction for effects of age and education and (2) test the efficacy of the statistically adjusted MMS (MMSAdj) as a screening tes t for dementia using different ethnic groups and education levels, We used a population-based community survey sample (n = 590) composed of 46.6% Hispanics and 53.4% non-Hispanics to derive the statistical corr ection, defined as: MMSAdj = Raw MMS - (0.471 x [Education-12]) + (0.1 31 x [Age-70]). Ethnicity and language of test administration were not significantly related to MMSAdj in the community survey sample, but t he raw MMS was strongly influenced by these factors. We used an indepe ndent sample (n = 2,983) of patients evaluated through the California Alzheimer's Disease Diagnostic and Treatment Centers to test the diagn ostic accuracy of the MMS and the MMSAdj across low- and high-educatio n groups and across whites, Hispanics, and blacks. Results showed grea ter stability of sensitivity and specificity across education levels a nd ethnic groups for the MMSAdj than for the raw MMS and suggest that the MMSAdj is a preferable measure of cognitive impairment for low-edu cation and minority individuals.