The influence of noncognitive factors on the mini-mental state examinationin older Mexican-Americans: Findings from the Hispanic EPESE

Mini-Mental State Examination data from the Hispanic Established Population for the Epidemiologic Study of the Elderly baseline survey, a population-b ased study of community dwelling Mexican Americans aged 65 and older, were used to examine the relationship between cognitive impairment, sociodemogra phics, and health-related characteristics. The rate of cognitive impairment found in this group of order Mexican Americans, using the conventional cut point of 23/24 on the MMSE, was 36.7%. Using a more conservative cut point of 17/18 indicated an overall rate of severe cognitive impairment of 6.7%. Rates of impairment varied significantly with age, education, literacy, ma rital status, language of interview, and immigrant status and were associat ed with high and moderate levels of depressive symptoms, and history of str oke. Importantly, although education was strongly related to poor cognitive performance, it was not a significant predictor of severe cognitive impair ment. Multivariate analyses further indicated that as a screen for cognitiv e impairment in order Mexican Americans, the MMSE is strongly influenced by these noncognitive factors. Scores may reflect test bias, secondary to cul tural differences or the level of education in this population. I CLIN EPID EMIOL 52;11:1095-1102, 1999. (C) 1999 Elsevier Science Inc. All rights rese rved.