The Bangla Adaptation of Mini-mental State Examination (BAMSE): An instrument to assess cognitive function in illiterate and literate individuals

The Mini-Mental State Examination (MMSE) is a brief global instrument used to assess cognitive abilities in the elderly, requiring literacy as a prere quisite. Such a precondition is impractical for populations with widespread illiteracy. The present study aimed to adapt the MMSE for the cultural con text of Bangladesh and for use in populations irrespective of literacy skil ls. In the Bangla Adaptation of Mini-mental State Examination (BAMSE), the MMSE items were changed in such a way that they would be applicable for ill iterate individuals, as well as being culturally relevant in Bangladesh. Al together 672 elderly, 262 literate and 410 illiterate individuals were test ed with the BAMSE. To enable comparison between the BAMSE and MMSE, the lit erate elderly were tested with both instruments. Test-retest reliability of the BAMSE was assessed in 54 randomly selected individuals. The results sh owed that, in comparison to the MMSE, the BAMSE demonstrated satisfactory t est properties, although reliable differences were found on some of the ind ividual items when the two instruments were compared. The association betwe en the two instruments was good (r = 0.57) and the test-retest reliability was satisfactory (r = 0.70). More importantly, the BAMSE was found to be le ss sensitive to age and education than the MMSE. Finally, our results sugge st that in the socio-cultural context of Bangladesh, irrespective of litera cy skills, the BAMSE is an instrument that can be used to assess cognitive function of the normal elderly. Copyright (C) 2000 John Wiley & Sons, Ltd.