Hostname: page-component-745bb68f8f-b6zl4 Total loading time: 0 Render date: 2025-01-18T20:52:28.776Z Has data issue: false hasContentIssue false
  • English
  • Français

Age-related cognitive decline and vision impairment affecting the detection of dementia syndrome in old age

Published online by Cambridge University Press:  03 January 2018

Friedel M. Reischies  and
Bernhard Geiselmann
Friedel M. Reischies*
Affiliation:
Department of Psychiatry, Freie Universität Berlin, Germany
Bernhard Geiselmann
Affiliation:
Department of Psychiatry, Freie Universität Berlin, Germany
*
PD Dr Friedel M. Reischies, Psychiatrische Klinik FU Berlin, Eschenallee 3,14050 Berlin, Germany
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Currently the Mini Mental State Examination (MMSE) is widely used as a screening instrument for dementia syndrome. Diagnostic validity may be lowered in old age by normal age-related cognitive decline. Furthermore, visual impairment, occurring frequently in old age, leads to missing values which prevent an interpretation of the test result.

Method

In the Berlin Ageing Study (n=516, age range 70–103 years) MMSE and clinical dementia diagnosis, made by a psychiatrist investigating all subjects by the Geriatric Mental State–A and History and Aetiology Schedule interviews, were investigated independently. The MMblind was analysed, an MMSE version for vision impairment in which all items requiring image processing are omitted. The study sample is population-based; dementia cases (DSM–III–R) were excluded on the basis of the clinical diagnosis.

Results

Norms are reported for very old age regarding MMSE as well as MMblind. There is a considerable age effect on MMSE scores. In contrast to MMSE, sensitivity and specificity of the shorter MMblind version are not reduced.

Conclusions

The considerable age effect requires the adaptation of cut-off values for old age. The blind version of the MMSE seems to be a valid instrument improving the applicability of the MMSE in old age.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 5 , November 1997 , pp. 449 - 451
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Bleecker, M. L., Bolla-Wilson, K., Kawas, C., et al (1988) Age-specific norms for the Mini-Mental State Examination. Neurology, 38, 1565–1568.Google Scholar
Copoland, J. R., Dewey, H. E. & Saunders, P. (1991) The epidemiology of dementia: GMS-AGECAT studies of prevalence and incidence, including studies in progress. European Archives of Psychiatry and Clinical Neuroscience, 240, 212–217.Google Scholar
Crum, R. M., Anthony, J. C., Basset, S. S., et al (1993) Population based norms for the mini-mental state examination by age and education level. Journal of the American Medical Association, 269, 2386–2391.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) “Mini Mental State”: a practical method for grading the cognitive state of patients for the clinician Journal of Psychiatric Research, 12, 189–198.Google Scholar
Fratiglioni, L., Jorm, A. F., Grut, M., et al (1993) Predicting dementia from the Mini Mental State Examination in an elderly population: the role of education. Journal of Clinical Epidemiology, 46, 281–287.Google Scholar
Klein, L. E., Roca, R. P., McArthur, J., et al (1985) Diagnosing dementia, univariate and multivariate analysis of the mini mental state examination. Journal of the American Geriatric Society, 33, 483–488.Google Scholar
Lindenberger, U. & Baltes, P. B. (1994) Sensory functioning and intelligence in old age: a strong connection. Psychology and Aging, 9, 339–355.Google Scholar
O'Connor, D. W., Pollitt, P. A., Hyde, J. B., et al (1989) The reliability and validity of the mini-mental state in a British community survey. Journal of the Psychiatry Research, 23, 87–96.Google Scholar
Paykel, E. S., Brayne, C., Huppert, F. A., et al (1994) Incidence of dementia in a population older than 75 years in the United Kingdom. Archives of General Psychiatry, 51, 325–332.Google Scholar
Van der Cammen, T. J., van Harskamp, F., Stronks, D. L., et al (1992) Value of the Mini-Mental State Examination and informants' data for the detection of dementia in geriatric outpatients. Psychological Reports, 71, 1003–1009.Google Scholar
Reischles, F. M., Schaub, R. T. & Schiattmann, P. (1998) Normal ageing, impaired cognitive functioning, and senile dementia - a mixture distribution analysis. Psychological Medicine, 26, 785–790.Google Scholar
Wernicke, T. & Reischies, F. M. (1994) Prevalence of dementia in old age: clinical diagnoses in subjects aged 95 and older. Neurology, 44, 250–253.Google Scholar
Ylikoski, R., Erkinjuntti, T., Sulkava, R., et al (1991) Correction for age, education and other demographic variables in the use of the Mini Mental State Examination in Finland. Acta Neurologica Scandinavica, 85, 392–396.Google Scholar
Zaudig, M., Mittelhammer, J., Hiller, W., et al (1991) SIDAM: a structured interview for the diagnosis of dementia of the Alzheimer type, multi infarct dementia and dementias of other aetiology according to ICD–0 and DSM–III–R. Psychological Medicine, 21, 225–236.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.