Journal List > Dement Neurocogn Disord > v.11(4) > 1120796

Dement Neurocogn Disord. 2012 Dec;11(4):146-153. Korean.
Published online Dec 31, 2012.  https://doi.org/10.12779/dnd.2012.11.4.146
Copyright© 2012 Korean Dementia Association
The Influence of Test-Retest Interval on the Significant Change Indices for the K-MMSE
Minji Song, M.A., Jihyang Kim, M.A.,* Kyung Ryu, Ph.D., Jihyun Kim, Ph.D., Juil Rie, Ph.D., and Yeonwook Kang, Ph.D.*,
Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
*Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Hallym University Institute of Aging, Chuncheon, Korea.
Department of Psychology, Hallym University, Chuncheon, Korea.

Address for correspondence: Yeonwook Kang, Ph.D. Department of Psychology, Hallym University, 39 Hallymdaehak-gil, Chuncheon 200-702, Korea. Tel: +82-33-248-1724, Fax: +82-33-256-3424, Email: ykang@hallym.ac.kr
Received Nov 14, 2012; Revised Dec 18, 2012; Accepted Dec 24, 2012.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Background

The Mini-Mental State Examination (MMSE) has been commonly used to measure cognitive change over time. The aim of present study was to investigate the normative rates of change for the MMSE across test-retest intervals.

Methods

We administered the Korean MMSE (K-MMSE) to 1055 community-dwelling middle aged and older adults three times over 6 years. Based on the Christensen's health screening criteria (1991), 234 middle-aged healthy adults (104 men, 130 women; mean age 55.95±6.20 years; age range 45-64 years; mean education 7.63±4.06 years) and 505 healthy elderly (200 men, 305 women; mean age 71.00±4.62 years; age range 65-79 years; mean education 5.61±5.12 years) were selected for the statistical analysis. Reliable change indices were computed using two different statistical methods, the Reliable Change Index adjusted for practice effects (RCIPE; Chelune et al., 1993) and the Standardized Regression-Based Change Index (SRBCI; McSweeny et al., 1993).

Results

For the middle-aged healthy adult group, the 90% confidence intervals of the RCIPE and SRBCI were the same such as ±4 in 2-year, ±5 in 4-year, and ±6 in 6-year test-retest intervals. For the healthy elderly group, the 90% confidence intervals of the RCIPE were -5 and +4 in 2-year interval and -7 and +5 in 4- & 6-year intervals. The 90% confidence intervals of the SRB change index were ±4 in 2-year interval and ±6 in 4- & 6-year intervals.

Conclusions

The result provides the normative data of the reliable change scores for the K-MMSE for the middle-aged and older adults. It shows that the reliable change indices were varied across different age groups as well as test-retest intervals.

Keywords: MMSE; Test-retest interval; Reliable change index; Standardized regression based change index

Figures


Fig. 1
Number of participants on each difference of score.
Click for larger image

Tables


Table 1
Reliable change scores and their formulas
Click for larger image


Table 2
Difference of scores between the baseline test and retests
Click for larger image


Table 3
Number (%) of participants on each difference of score
Click for larger image


Table 4
Prediction intervals of reliable change scores across test-retest intervals
Click for larger image


Table 5
Significant change scores across test-retest intervals and number (%) of participants who showed significantscore change in the K-MMSE
Click for larger image

References
1. Folstein MF, Folstein SE, McHugh PR. "Mini-Mental State": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
2. Bondi MW, Salmon DP, Kaszniak AW. The neuropsychology of dementia. In: Grant I, Adams KM, editors. Neuropsychological assessment of neuropsychiatric disorders. New York: Oxford University Press; 1996.
3. Kang Y. A normative study of the Korean-Mini Mental State Examination (K-MMSE) in the elderly. Korean J Psychol Gen 2006;25:1–12.
4. Schmand B, Lindeboom J, Launer L, Dinkgreve M, Hooijer C, Jonker C. What is a significant score change on the Mini-Mental State examination? Int J Geriatr Psychiatry 1995;10:411–414.
5. Heilbronner RL, Sweet JJ, Attix DK, Krull KR, Henry GK, Hart RP. Official position of the American Academy of Clinical Neuropsychology on serial neuropsychological assessments: the utility and challenges of repeat test administrations in clinical and forensic contexts. Clin Neuropsychol 2010;24:1267–1278.
6. Duff K. Evidence-based indicators of neuropsychological change in the individual patient: relevant concepts and methods. Arch Clin Neuropsychol 2012;27:248–261.
7. Dirks J. The effect of a commercial game on children's block design scores in the WISC-R IQ test. Intelligence 1892;6:109–123.
8. Rapport LJ, Brines DB, Axelrod BN, Theisen ME. Full scale IQ as a mediator of practice effects: the rich get richer. Clin Neuropsychol 1997;11:375–380.
9. Beglinger LJ, Gaydos B, Tangphao-Daniels O, Duff K, Kareken DA, Crawford J, et al. Practice effects and the use of alternate forms in serial neuropsychological testing. Arch Clin Neuropsychol 2005;20:517–529.
10. Heaton RK, Temkin N, Dikmen S, Abitable N, Taylor MJ, Marcotte TD, et al. Detecting change: a comparison of three neuropsychological methods, using normal and clinical samples. Arch Clin Neuropsychol 2001;16:75–91.
11. Tombaugh TN. Test-retest reliable coefficients and 5-year change scores for the MMSE and 3MS. Arch Clin Neuropsychol 2005;20:485–503.
12. Hensel A, Angermeyer MC, Riedel-Heller SG. Measuring cognitive change in older adults: reliable change in dices for the MMSE. J Neurol Neurosurg Psychiatry 2007;78:1298–1303.
13. Frerichs RJ, Tuokko HA. A comparison of methods for measuring cognitive change in older adults. Arch Clin Neuropsychol 2005;20:321–333.
14. Chelune GJ, Naugle RI, Luders H, Sedlak J, Awad IA. Individual change after epilepsy surgery: practice effects and base-rate information. Neuropsychology 1993;7:41–52.
15. McSweeny AJ, Naugle RI, Chelune GJ, Luders H. T scores for change: an illustration of a regression approach to depicting change in clinical neuropsychology. Clin Neuropsychol 1993;7:300–312.
16. Hallym Institue of Aging. Quality of life in the Korean elderly. Chuncheon: Hallym University Press; 2006.
17. Christensen KJ, Multhaup KS, Nordstrom S, Voss K. A cognitive battery for dementia: development and measurement characteristics. Psychol Assess 1991;3:168–174.
18. Clark CM, Sheppard L, Fillenbaum GG, Galasko D, Morris JC, Koss E, et al. Variability in Annual Mini-Mental State Examination score in patients with probable Alzheimer Disease. Arch Neurol 1999;56:857–862.