Study of Mini-Mental State Exam evolution in community-dwelling subjects aged over 60 years without dementia.

Objective: In recent years, the Mini-Mental State Examination (MMSE) has been widely used and has been proposed for cognitive decline screening in the framework of a systematic geriatric evaluation in health centers. The aim of the present longitudinal study was to identify the potential determinants of MMSE score and its evolution over a 4-year period in a population aged over sixty years with good general health without dementia and consulting for a health check-up.

Design: Longitudinal study.

Setting: The preventive medical center (CMP) in Nancy.

Participants: 687 subjects over 60 years of age (mean age 65.6 ± 5.07 years) were included from the Senior health examination study.

Measurements: All subjects underwent 2 visits over a period of 4 years. MMSE measurement and a self-administered questionnaire of emotional and psychological state were evaluated at baseline and at the follow-up visit.

Results: The major components of total variance of baseline MMSE were represented by education level, practice of regular physical activity, nervousness and despair. Multivariate analysis identified 3 variables at baseline visit that independently predicted annual changes in MMSE: MMSE score, education level and "Difficulty in social relations" (r= -0.222, 0.154 and -0.255 respectively).

Conclusions: Education level and several psychological factors may influence MMSE score and its evolution over time in community-dwelling subjects aged over 60 years without dementia. In these subjects, a low MMSE score does not predict cognitive decline over a period of 4 years. Therefore, the reliability of MMSE in this type of population is questionable.