PERFORMANCE ON A DEMENTIA SCREENING-TEST IN RELATION TO DEMOGRAPHIC-VARIABLES - STUDY OF 5297 COMMUNITY RESIDENTS IN TAIWAN

Objective: To examine the relation between performance on a dementia s creening test and the demographic variables of age, education, gender, and urban vs rural residency. Design: Community survey with cluster s ampling. Setting: One urban and one rural community from each of four geographic regions in Taiwan, Republic of China. Participants: A total of 5265 nondemented individuals approximately equally divided between men and women and between urban and rural residency with a range in a ge from 41 to 88 years and in education from 0 to 20 years. Main Outco me Measure: Score on a Chinese adaptation of the Mini-Mental State Exa mination. Results: Lower test scores were associated with older age an d less education. The decrease in score with age was faster among part icipants who had never attended school. Better performance by men and by urban residents was found only among participants with fewer than 6 years of schooling. In this group, the magnitudes of sex and residenc y differences were comparable among those subjects aged 41 to 64 years and those aged 65 to 88 years. Women who had never worked outside of the home performed poorer than those who had worked outside of the hom e. Conclusions: The influence of educational background on test perfor mance is most evident in individuals with less education. Commonly use d dementia screening tests may be unfair to poorly educated individual s, especially women and rural residents. Efforts should be made to dev elop ecologically relevant cognitive tests for the intended study popu lations. To help distinguish test bias from different rates of cogniti ve decline, the study populations should include individuals in predem entia age ranges.