title: Study of Mini-Mental State Exam evolution in community-dwelling subjects aged over 60 years without dementia.
abstract: OBJECTIVE
  In recent years, the Mini-Mental State Examination (MMSE) has been widely used and has been proposed for cognitive decline screening in the framework of a systematic geriatric evaluation in health centers. The aim of the present longitudinal study was to identify the potential determinants of MMSE score and its evolution over a 4-year period in a population aged over sixty years with good general health without dementia and consulting for a health check-up.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  The preventive medical center (CMP) in Nancy.
  
  
  METHODS
  687 subjects over 60 years of age (mean age 65.6 ± 5.07 years) were included from the Senior health examination study.
  
  
  METHODS
  All subjects underwent 2 visits over a period of 4 years. MMSE measurement and a self-administered questionnaire of emotional and psychological state were evaluated at baseline and at the follow-up visit.
  
  
  RESULTS
  The major components of total variance of baseline MMSE were represented by education level, practice of regular physical activity, nervousness and despair. Multivariate analysis identified 3 variables at baseline visit that independently predicted annual changes in MMSE: MMSE score, education level and "Difficulty in social relations" (r= -0.222, 0.154 and -0.255 respectively).
  
  
  CONCLUSIONS
  Education level and several psychological factors may influence MMSE score and its evolution over time in community-dwelling subjects aged over 60 years without dementia. In these subjects, a low MMSE score does not predict cognitive decline over a period of 4 years. Therefore, the reliability of MMSE in this type of population is questionable.
authors.affiliation: Department of Geriatrics, Centre d'Etudes et de Formation sur le Vieillissement (EFORVIE) and Memory Clinic, Centre Mémoire de Ressources et de Recherche (CMRR), University Hospital of Nancy, Nancy, France.
authors.forename: G
authors.initials: G
authors.lastname: Watfa
authors.forename: N
authors.initials: N
authors.lastname: Husson
authors.forename: S
authors.initials: S
authors.lastname: Buatois
authors.forename: M C
authors.initials: MC
authors.lastname: Laurain
authors.forename: P
authors.initials: P
authors.lastname: Miget
authors.forename: A
authors.initials: A
authors.lastname: Benetos
mesh_terms: D000342:Affective Symptoms / Q000175:diagnosis*; D000368:Aged; D001007:Anxiety / Q000175:diagnosis; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D003704:Dementia; D004522:Educational Status; D015444:Exercise; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D008603:Mental Health; D008609:Mental Status Schedule / Q000592:standards*; D008875:Middle Aged; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000175:diagnosis; D012016:Reference Values; D015203:Reproducibility of Results; D013315:Stress, Psychological