title: The MMSE orientation for time domain is a strong predictor of subsequent cognitive decline in the elderly.
abstract: BACKGROUND
  The mini-mental state exam (MMSE) has been used to address questions such as determination of appropriate cutoff scores for differentiation of individuals with intact cognitive function from patients with dementia and rate of cognitive decline. However, little is known about the relationship of performance in specific cognitive domains to subsequent overall decline.
  
  
  OBJECTIVE
  To examine the specific and/or combined contribution of four MMSE domains (orientation for time, orientation for place, delayed recall, and attention) to prediction of overall cognitive decline on the MMSE.
  
  
  METHODS
  Linear mixed models were applied to 505 elderly nursing home residents (mean age = 85, > 12 years education = 27%; 79% F, mean follow-up = 3.20 years) to examine the relationship between baseline scores of these domains and total MMSE scores over time.
  
  
  RESULTS
  Orientation for time was the only domain significantly associated with MMSE decline over time. Combination of poor delayed recall with either attention or orientation for place was associated with significantly increased decline on the MMSE.
  
  
  CONCLUSIONS
  The MMSE orientation for time predicts overall decline on MMSE scores over time. A good functioning domain added to good functioning delayed recall was associated with slower rate of decline.
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA. elizabeth.guerrero-berroa@mssm.edu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Guerrero-Berroa
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Luo
authors.forename: James
authors.initials: J
authors.lastname: Schmeidler
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rapp
authors.forename: Karen
authors.initials: K
authors.lastname: Dahlman
authors.forename: Hillel T
authors.initials: HT
authors.lastname: Grossman
authors.forename: Vahram
authors.initials: V
authors.lastname: Haroutunian
authors.forename: Michal Schnaider
authors.initials: MS
authors.lastname: Beeri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D016014:Linear Models; D008297:Male; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D009735:Nursing Homes; D011237:Predictive Value of Tests