COGNITIVE SCREENING IN A POPULATION-BASED SAMPLE OF COMMUNITY-LIVING ELDERLY - EFFECTS OF AGE AND EDUCATION ON THE CONSTRUCT OF COGNITIVE STATUS

This study examined the measurement properties of a cognitive screenin g test, the Halifax Mental Status Scale (HMSS), in a population-based sample of community-living elderly subjects (N = 361) and a clinic sam ple (N = 20) of patients with Alzheimer's disease. Receiver operating characteristic analyses yielded estimates of sensitivity and specifici ty of approximately 90% for this test. Factor analysis confirmed a thr ee-factor solution for the HMSS. Although both age and education were correlated with the HMSS total score, their relationship to the factor scores differed. Our study shows that comprehensive cognitive status tests do not measure a unitary construct and that adjustment of summar y scores for education is unlikely to optimize sensitivity and specifi city. In population-based studies, only those components of a test tha t reflect education should be adjusted.