title: Cognitive impairment using education-based cutoff points for CMMSE scores in elderly Chinese people of agricultural and rural Shanghai China.
abstract: OBJECTIVE
  To evaluate cognitive impairment (CI) in rural China using the Chinese version of the Mini-Mental Status Examination (CMMSE) and compare the prevalence of CI using two different cutoff points.
  
  
  METHODS
  A population-based survey was conducted of 2809 people aged 60 years and above in a community of two towns (Huaxin and Xujing) in the Qingpu district, located in the western suburb of Shanghai. Face-to-face interviews were carried out to collect relevant information with questionnaires. The Chinese version of the Mini-Mental State Examination with either a 23/24 cutoff point or a cutoff point varying according to education level (AEL) was used to screen subjects for CI.
  
  
  RESULTS
  Among these subjects, the mean age was 70.6 years (SD = 6.6) and ranged from 60 to 92 years and included 1010 (36.0%) men and 1799 (64.0%) women. The mean age was 70.7 years (SD = 6.4) for men and 70.5 years (SD = 6.7) for women. Of the 2809 subjects, 2010 (71.5%) had no formal education, 607 (21.6%) completed 1-6 years of education, and 173 (6.2%) completed more than 6 years of school education. The prevalence of CI was 35.6% (95% CI: 33.8-37.4) for both genders when the cutoff point of 23/24 was used. However, when the cutoff point was altered with respect to different education levels, the prevalence of CI was 7.0%. For each item of the CMMSE, increased years of education correlated with a higher item score, with the exception of the 'Naming' item score.
  
  
  CONCLUSIONS
  This study demonstrates that screening of CI using the AEL cutoff scores is feasible in a low-education population. Determining whether the 23/24 cutoff point is suitable for the Chinese people requires future prospective studies in a large Chinese population.
authors.affiliation: Department of Neurology, Ruijin Hospital Affiliated with the School of Medicine, Shanghai Jiao Tong University, China.
authors.forename: G-H
authors.initials: GH
authors.lastname: Cui
authors.forename: Y-H
authors.initials: YH
authors.lastname: Yao
authors.forename: R-F
authors.initials: RF
authors.lastname: Xu
authors.forename: H-D
authors.initials: HD
authors.lastname: Tang
authors.forename: G-X
authors.initials: GX
authors.lastname: Jiang
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: G
authors.initials: G
authors.lastname: Wang
authors.forename: S-D
authors.initials: SD
authors.lastname: Chen
authors.forename: Q
authors.initials: Q
authors.lastname: Cheng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data