Mini Mental State Examination (MMSE)

The Mini International Neuropsychiatric Interview (MINI) (section: mental health) was measured in all elderly Lifelines participants during:

• 1A Visit 1 (65+, n = ~13.000)
• 3A Visit 1 (65+)

The Mini Mental State Examination (MMSE) is a brief cognition test used to assess cognitive impairments (section: mental health). It is commonly used in medicine and allied health to screen for dementia.
The MMSE was performed in ca. 12.000 elderly (65+) participants during 1A Visit 1. ~12% scored below 24 points (NB: in case of an MMSE score <26 at 1A visit 1, the Proxy interview was performed on location).
The MMSE is implemented again in 3A Visit 1
The MMSE is used in conjunction with other cognition tests in Lifelines, i.e. the RFFT (also during 1A Visit 1 and 3A Visit 1) and the CogState (during 2A visit 1 and 3A Visit 1), and with several cognition-related questions. The MMSE should not be confused with the Mini Neuropsychiatric Interview, which is also used in Lifelines but assesses anxiety and depression.

De MMSE includes simple questions and tasks in a number of areas:

• orientation (V1a-e, V2a-e, max. 10 points);
• registration (V3, max. 3 points);
• attention and calculation (V4, max. 5 points);
• recall (V5, max. 3 points);
• language (V6-10, max. 8 points);
• basic motor skills (V11, max. 1 point, copy a drawing of two pentagons as shown in figure).

A total of 30 points can be scored in the MMSE (see English protocol for details on scoring). The final score will give a first indication of the presence and level of cognitive impairment (but note that the MMSE is not a diagnostic instrument).

• 24-30 points: No cognitive impairment
• 18-23 points: Mild to moderate cognitive impairment
• 0-17 points: Severe cognitive impairment

Note that in Lifelines, the computer programme gave the following raw data scores:

• 12 out of 30 items were scored as 1 for correct and 0 for incorrect
• 18 out of 30 items were scored as 2 for correct and 1 for incorrect

The programme therefore subtracted 1 from each score in these 18 items to get the final score.
When raw MMSE data are used for calculations, the same subtraction should be made.
The Lifelines protocol of the MMSE (in Dutch) can be downloaded here: mmse_in_dutch.pdf
The English equivalent can be downloaded here: mmse_in_english.pdf