title: Norms of the Mini-Mental state Examination for Japanese subjects that underwent comprehensive brain examinations: the Kashima Scan Study.
abstract: OBJECTIVE
  The distribution of the Mini-Mental State Examination (MMSE) scores by age and educational level was investigated in subjects that underwent comprehensive brain examinations.
  
  
  METHODS
  This cross-sectional study included 1,414 adults without neurological disorders who underwent health-screening tests of the brain, referred to as the "Brain Dock," in our center. The MMSE scores were compared between age groups (40-44, 45-49, 50-54, 55-59, 60-64, 65-69, or ≥70 years) and educational levels [the low education level group (6-12 years) and the high education level group (≥13 years)].
  
  
  RESULTS
  The median age was 59 years, and 763 (54%) were women. There was no significant difference in the MMSE total score between women and men. The stepwise method of the multiple linear regression analysis confirmed that a higher age [β value, -0.129; standard error (S.E.), 0.020; p<0.001], low education level (6-12 years) (β value, -0.226; S.E., 0.075; p=0.003), and women (β values, 0.148; S.E., 0.066; p=0.024) was significantly associated with decreased MMSE score. In general, both the percentile scores and mean scores decreased with aging and were lower in the low education level group than in the high education level group. The degree of decrement in scores with age was stronger in the low education level group than in the high education level group.
  
  
  CONCLUSIONS
  The provided data for age- and education-specific reference norms will be useful for both clinicians and investigators who perform comprehensive brain examinations to assess the cognitive function of subjects.
authors.affiliation: Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yakushiji
authors.forename: Etsuo
authors.initials: E
authors.lastname: Horikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Eriguchi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nanri
authors.forename: Masashi
authors.initials: M
authors.lastname: Nishihara
authors.forename: Tatsumi
authors.initials: T
authors.lastname: Hirotsu
authors.forename: Hideo
authors.initials: H
authors.lastname: Hara
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007564:Japan; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012016:Reference Values; D012737:Sex Factors