Cut-off Score on MMSE-K for Screening of Dementia in Community Dwelling Old People

ABSTRACT

OBJECTIVES: This study aimed to estimate the optimal cut-off score on Korean version of Mini-Mental State Examination (MMSE-K) for screening of dementia in community dwelling old people, and to investigate possible changes of the cut-off score according to age, gender, educational level, living area, and depression of the old people. METHODS: For the old people aged 65 or over dwelling in two areas of Kwangju, cognitive function (MMSE-K) and demographic characteristics (age, gender, educational level, living area) were investigated. For those scoring 24 or less on MMSE-K of them, clinical diagnosis of dementia (DSM-IV) and depression (Hamilton Rating Scale for Depression) were assessed. The optimal cut-off score on MMSE-K with a sensitivity and a specificity was examined by using receiver operating characteristics curve analysis served by diagnosis of dementia as a gold standard. Associations of the cut-off score on MMSE-K with demographic characteristics and depression were estimated by odds ratios. For those factors showing significant association with cut-off score on MMSE-K regardless of the diagnosis of dementia, the optimal cut-off scores on MMSE-K were measured again at each level. RESULTS: In the old people scoring 24 or less on MMSE-K (n=341), the optimal cut-off score on MMSE-K served by diagnosis of dementia was 21/22 with a sensitivity of 81% and a specificity of 64%. Only the age among the investigated characteristics was significantly associated with the cut-off score on MMSE-K, and the optimal cut-off score in those aged 75 or over was revealed to be 20/21. CONCLUSIONS: We suggest that the cut-off score on MMSE-K for screening of dementia investigated in this study could be used by community health care staff as a guideline for assessing old people with questionable cognitive dysfunction or for considering to consult them to an expert.