In:
Neuroepidemiology, S. Karger AG, Vol. 43, No. 1 ( 2014), p. 15-25
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The Mini-Mental State Examination (MMSE) is widely used in population-based longitudinal studies to quantify cognitive change. However, its poor metrological properties, mainly ceiling/floor effects and varying sensitivity to change, have largely restricted its usefulness. We propose a normalizing transformation that corrects these properties, and makes possible the use of standard statistical methods to analyze change in MMSE scores. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The normalizing transformation designed to correct at best the metrological properties of MMSE was estimated and validated on two population-based studies (n = 4,889, 20-year follow-up) by cross-validation. The transformation was also validated on two external studies with heterogeneous samples mixing normal and pathological aging, and samples including only demented subjects. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The normalizing transformation provided correct inference in contrast with models analyzing the change in crude MMSE that most often lead to biased estimates of risk factors and incorrect conclusions. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Cognitive change can be easily and properly assessed with the normalized MMSE using standard statistical methods such as linear (mixed) models.
Type of Medium:
Online Resource
ISSN:
0251-5350
,
1423-0208
Language:
English
Publisher:
S. Karger AG
Publication Date:
2014
detail.hit.zdb_id:
1483032-2
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