title: [Cognitive impairment and cardiovascular disease risk factors. Project CASCADE Kraków. II. Agreement of Mini-Mental State Examination (MMSE) obtained by nurses and by psychologists from the same persons at age 67-78 years of age].
abstract: Mini-Mental State Examination (MMSE) can be used for screening procedures by personnel with no university training in psychology. However, little is known on the reliability of the results of MMSE obtained by medical personnel with little experience in cognitive function assessment. The goal of the paper was to assess the agreement between the results of MMSE obtained by trained community nurses and by psychologists, and to study whether the agreement depends on age, sex and education of examined persons. Studied group were 92 women and 90 men at age 65-78 years. Most of them (81.3%) had only elementary education. There was no significant difference between the distribution of the results obtained by nurses and obtained by psychologists. Individual difference < or = 2 points was found in 63.1% participants and difference < or = 3 points in 78.4% participants. There was a significant correlation between the results obtained by nurses and by psychologists (r = 0.64, p < 0.001). The correlation was also significant within the age, sex and education strata. Variation of the results obtained by nurses was explained in 42% by variation of the results obtained by psychologists. The best agreement in classification in cognitive function was found for the MMSE cut-off point < or = 19 (kappa = 0.75 in women and kappa = 0.58 in men). The worst agreement was found for the cut-off point < or = 25. Also weak agreement was found for the cut-off point < or = 23. There was a significant agreement between the results of MMSE obtained by nurses and results obtained by psychologists on the population level. However at the level of individuals the agreement in classification of cognitive function depended of cut-off point used. The agreement was only fair if cut-off point < or = 23 and < or = 25 were used.
authors.affiliation: Pracowni Epidemiologii Klinicznej i Badań Populacyjnych, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
authors.forename: E
authors.initials: E
authors.lastname: Pomykalska
authors.forename: A
authors.initials: A
authors.lastname: Pajak
authors.forename: A
authors.initials: A
authors.lastname: Szczudlik
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003072:Cognition Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D003152:Community Health Nursing / Q000592:standards; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000451:nursing / Q000592:standards*; D008609:Mental Status Schedule / Q000592:standards*; D015588:Observer Variation; D011044:Poland / Q000453:epidemiology; D011584:Psychology / Q000295:instrumentation; D015203:Reproducibility of Results