The Mini-Mental State Examination: Czech Norms and Cutoffs for Mild Dementia and Mild Cognitive Impairment due to Alzheimer's Disease

Abstract

Background: There is a lack of normative studies of the Mini-Mental State Examination (MMSE) for comparison with early Alzheimer's disease (AD) according to new diagnostic criteria. Participants and Methods: We administered the MMSE to normal elderly Czechs and to patients with mild cognitive impairment (MCI) and mild dementia due to AD according to NIA-AA criteria. Results: We established percentile- and standard deviation-based norms for the MMSE from 650 normal seniors (age 69 ± 8 years, education 14 ± 3 years, MMSE score 28 ± 2 points) stratified by education and age. Dementia patients scored significantly lower than the MCI patients and both groups (110 early AD patients) had significantly lower MMSE scores than the normal seniors (22 ± 5 or 25 ± 3 vs. 28 ± 2 points) (p < 0.01). The optimal cutoff was ≤27 points with sensitivity of 86% and specificity of 79% for early detection of AD patients. Conclusion: We provided MMSE norms, several cutoffs, and higher cutoff scores for early AD using recent guidelines.