Score Disparity Between the MMSE and the SLUMS

Abstract

Background: Multiple brief cognitive instruments are available to assess cognitive impairment in older adults. However, not all instruments demonstrate the same effectiveness when utilized with higher educated adults. This study evaluates the score disparity between the Mini-Mental State Examination (MMSE) and the St. Louis University Mental Status (SLUMS) Examination across the education spectrum. It was hypothesized that individuals with more years of formal education would produce higher scores on both the MMSE and SLUMS. Previous research was conducted to create a conversion scale used to compare and convert the MMSE scores to SLUMS scores. This research study provides additional data to add to the body of knowledge regarding a conversion scale for the MMSE and SLUMS. Methods: Seventy-five adults older than the age of 60 years were each administered the MMSE and SLUMS. Results: Contrary to our hypothesis, individuals with more years of formal education did not produce significantly greater scores on the MMSE or SLUMS. Likewise, education level analyzed as a continuous measure was not significantly correlated with the MMSE, r(75) = −0.191, or SLUMS, r(75) = 0.019. Interestingly, among participants with a high (but not low) education level, there was a marginal but significant difference in mean score between the MMSE (29.00 ± 1.47) and SLUMS (27.74 ± 3.08), t(64) = 3.70, P < .001. Conclusion: Other factors besides education may impact the performance of older adults on the MMSE and SLUMS, but it does appear that education level may moderate the score disparity between the 2 instruments. Additional studies are needed before using the MMSE to predict the score on the SLUMS and vice versa.