POPULATION-BASED NORMS FOR THE MINI-MENTAL-STATE-EXAMINATION BY AGE AND EDUCATIONAL-LEVEL

Objective.-To report the distribution of Mini-Mental State Examination (MMSE) scores by age and educational level. Design.-National Institut e of Mental Health Epidemiologic Catchment Area Program surveys conduc ted between 1980 and 1984. Setting.-Community populations in New Haven , Conn; Baltimore, Md; St Louis, Mo; Durham, NC; and Los Angeles, Cali f. Participants.-A total of 18 056 adult participants selected by prob ability sampling within census tracts and households. Main Outcome Mea sures.-Summary scores for the MMSE are given in the form of mean, medi an, and percentile distributions specific for age and educational leve l. Results.-The MMSE scores were related to both age and educational l evel. There was an inverse relationship between MMSE scores and age, r anging from a median of 29 for those 18 to 24 years of age, to 25 for individuals 80 years of age and older. The median MMSE score was 29 fo r individuals with at least 9 years of schooling, 26 for those with 5 to 8 years of schooling, and 22 for those with 0 to 4 years of schooli ng. Conclusions.-Cognitive performance as measured by the MMSE varies within the population by age and education. The cause of this variatio n has yet to be determined. Mini-Mental State Examination scores shoul d be used to identify current cognitive difficulties and not to make f ormal diagnoses. The results presented should prove to be useful to cl inicians who wish to compare an individual patient's MMSE scores with a population reference group and to researchers making plans for new s tudies in which cognitive status is a variable of interest.