The distribution of Mini-Mental State Examination scores in an older UK African-Caribbean population compared to MRC CFA study norms.
OBJECTIVE
to describe normative data for the Mini-Mental State Examination (MMSE) in a UK African-Caribbean population and compare these with norms for white UK-born elders.


METHODS
a comparison of MMSE data from two cross-sectional surveys.


METHODS
the MMSE had been administered to a community UK African-Caribbean population and scores were compared to norms from the Medical Research Council Cognitive Function and Ageing Study (CFAS). MMSE data were analysed for 248 African-Caribbean participants aged 55-75 and 5379 CFAS participants aged 65-74, without visual or auditory problems. Distributions of scores were tabulated and error rates for individual items compared.


RESULTS
Median MMSE scores were 25 (interquartile range 22-27) for the whole African-Caribbean sample, 24 (22-27) for those aged 65-75 in the African-Caribbean sample, and 27 (25-29) for CFAS. Differences in error rates were specific to particular items: naming the season, serial seven subtraction, phrase repetition, three-stage command, and copying intersecting pentagons. These differences persisted when both samples were restricted to those with statutory duration of education, who were literate and who had worked in non-manual occupations. Normative data are displayed for MMSE scores in both groups.


CONCLUSIONS
different distributions of MMSE scores between UK African-Caribbean and Caucasian groups can be principally explained by cultural bias in certain items. If the MMSE is to be administered to older African-Caribbean people, specific normative data should be referred to or else a culturally modified version of the instrument should be used.
Stewart
Robert
R
Section of Epidemiology, Institute of Psychiatry, London, UK. R.Stewart@iop.kcl.ac.uk
Johnson
Jo
J
Richards
Marcus
M
Brayne
Carol
C
Mann
Anthony
A
D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis* / Q000208:ethnology*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D014481:United States / Q000453:epidemiology; D014900:West Indies / Q000208:ethnology