The Influence of Test-Retest Interval on the Significant Change Indices for the K-MMSE

Minji Song; Jihyang Kim; Kyung Ryu; Jihyun Kim; Juil Rie; Yeonwook Kang

doi:10.12779/dnd.2012.11.4.146

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

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Song, Kim, Ryu, Kim, Rie, and Kang: The Influence of Test-Retest Interval on the Significant Change Indices for the K-MMSE

Original Article

Dementia and Neurocognitive Disorders

Dementia and Neurocognitive Disorders 2012; 11(4): 146-153.

Published online: 31 December 2012

DOI: https://doi.org/10.12779/dnd.2012.11.4.146

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.^‡, 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, ykang@hallym.ac.kr

Received 14 November 2012 Revised 18 December 2012 Accepted 24 December 2012

(open-access):

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 (RCI_PE; 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 RCI_PE 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 RCI_PE 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 and Tables

Fig. 1

Number of participants on each difference of score.

Table 1

Reliable change scores and their formulas

RCI_PE, Reliable Change Index adjusted for Practice Effect; SRBCI, Standardized Regression-Based Change Index; T₁, score at Time 1; T₂, score at Time 2; D, mean of difference of score at Time 2 and score at Time 1; SED, Standard Error of the Difference; T'₂, predicted score at Time 2 based on the regression model; SEE, Standard Error of the Estimate of the regression model.

Table 2

Difference of scores between the baseline test and retests

^aMean difference score was calculated by subtracting the baseline (earlier) score from the retest (later) score; ^bPercentages of baseline scores was calculated by dividing the retest (later) score by the baseline (earlier) score.

^*p<0.05, ^†p<0.01, ^‡p<0.001.

Table 3

Number (%) of participants on each difference of score

Table 4

Prediction intervals of reliable change scores across test-retest intervals

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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