Dimensions underlying the mini-mental state examination in a sample with low-education levels: the Bambuí health and aging study.
OBJECTIVE
To investigate the validity of previously suggested dimensions underlying the Mini-Mental State Examination (MMSE) and differences in associations of these dimensions with sociodemographic and health characteristics in an older Latin-American community sample with low levels of education.


METHODS
Secondary analysis of baseline data from a population-based cohort study.


METHODS
Bambuí, Brazil.


METHODS
Of 1,742 total residents aged 60 years or older, 1,558 (89.4%) participated at this study.


METHODS
A standard Brazilian version of the MMSE.


RESULTS
A five-factor solution (Concentration, Language/Praxis, Orientation, Attention, and Memory) for the MMSE was generated from Principal Components Analysis, and the five-factor solutions proposed in previous studies of developed nation samples were tested in this sample by Confirmatory Factor Analysis. In the adjusted linear regression models, MMSE factors varied in their correlates: for example, female gender was associated with higher concentration, orientation, and attention but lower Language/Praxis; increased age was inversely associated only with language and attention; and activity of daily living impairment was principally associated with lower Language/Praxis.


CONCLUSIONS
This study provides support for the cross-sectional equivalence of the MMSE, suggesting that most of the items and underlying constructs remain meaningful after alteration and translation in a low-education sample with lower overall distribution of scores.
Castro-Costa
Erico
E
Laboratório de Epidemiologia e Antropologia Médica, Instituto René Rachou da Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil. castro-costa@cpqrr.fiocruz.br
Fuzikawa
Cintia
C
Ferri
Cleusa
C
Uchoa
Elizabeth
E
Firmo
Joselia
J
Lima-Costa
Maria Fernanda
MF
Dewey
Michael E
ME
Stewart
Robert
R
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001288:Attention; D001938:Brazil; D002908:Chronic Disease / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis*; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007802:Language; D008297:Male; D008568:Memory; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012737:Sex Factors