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

Dement Neurocogn Disord. 2012 Dec;11(4):146-153. Korean.
Published online Dec 31, 2012.
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:
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 ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



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.


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).


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.


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


Fig. 1
Number of participants on each difference of score.
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Table 1
Reliable change scores and their formulas
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Table 2
Difference of scores between the baseline test and retests
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Table 3
Number (%) of participants on each difference of score
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Table 4
Prediction intervals of reliable change scores across test-retest intervals
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Table 5
Significant change scores across test-retest intervals and number (%) of participants who showed significantscore change in the K-MMSE
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