Mini-mental state examination and mattis dementia rating scale performancediffers in Hispanic and non-Hispanic Alzheimer's disease patients

Little information exists regarding the performance of Spanish-speaking ver sus English-speaking patients with Alzheimer's disease (AD) on the Mini-Men tal State Examination and the Mattis Dementia Rating Scale. In an attempt t o identify culturally biased MMSE items or DRS subscales, we matched Spanis h-speaking Hispanic and English-speaking non-Hispanic White community-dwell ing AD patients by their MMSE scores and examined specific items within eac h scale. Our findings indicate that Hispanic AD patients perform significan tly worse than non-Hispanics in terms of total DRS score, scores on the DRS subscales for Conceptualization and Memory, and on serial subtraction (or backward spelling item) of the MMSE. While mildly to moderately demented Hi spanic and non-Hispanic patients obtained comparable scores on the DRS, sev erely impaired Spanish-speaking participants obtained considerably lower DR S scores than their English-speaking counterparts. The discrepancy in the D RS scores of the severely impaired Hispanic and non-Hispanic examinees mig ht reflect a cultural bias in the test or educational differences between t he groups. Alternatively, the DRS may be more sensitive than the MMSE for d etecting severe cognitive impairment in Hispanic patients.