WHAT IS A SIGNIFICANT SCORE CHANGE ON THE MINI-MENTAL-STATE-EXAMINATION

The distribution of change scores of the Mini-Mental State Examination (MMSE) was assessed in healthy aged subjects after an interval of 1 y ear. As part of the Amsterdam Study of the Elderly, which is a communi ty survey on ageing and cognitive decline (N = 4051; age range 65-84), a subsample of subjects (N = 247) was studied twice. Participants wit h dementia, other psychiatric disorders or physical disease which migh t interfere with cognitive testing were excluded. Test-retest reliabil ity was 0.55 in this group. The distribution of change scores ranged f rom -9 to +5. From this result the following clinical rule-of-thumb wa s derived. In an individual patient, and in the absence of other indic ations of a dementing process, a deterioration in MMSE score must be g reater than five points after 1 year to be suspect for a genuine cogni tive decline.