title: The distribution of Mini-Mental State Examination scores in an older UK African-Caribbean population compared to MRC CFA study norms.
abstract: 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.
authors.affiliation: Section of Epidemiology, Institute of Psychiatry, London, UK. R.Stewart@iop.kcl.ac.uk
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
authors.forename: Jo
authors.initials: J
authors.lastname: Johnson
authors.forename: Marcus
authors.initials: M
authors.lastname: Richards
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.forename: Anthony
authors.initials: A
authors.lastname: Mann
mesh_terms: 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