Mini-Mental State Examination as a Predictor of Mortality among Older People Referred to Secondary Mental Healthcare

Abstract Background: Anticholinergic medication use is linked with increased cognitive decline, dementia, falls and mortality, and their use should be limited in older people. Here we estimate the prevalence of anticholinergic use in England’s older population in 1991 and 2011, and describe changes in use by participant’s age, sex, cognition and disability.Methods: We compared data from participants aged 65+ years from the Cognitive Function and Ageing Studies (CFAS I and II), collected during 1990-1993 (N=7,635) and 2008-2011 (N=7,762). We estimated the prevalence of potent anticholinergic use (Anticholinergic Cognitive Burden [ACB] score=3) and average anticholinergic burden (sum of ACB scores), using inverse probability weights standardised to the 2011 UK population. These were stratified by age, sex, Mini-Mental State Examination score, and activities of daily living (ADL) or instrumental ADL (IADL) disability. Results: Prevalence of potent anticholinergic use increased from 5.7% (95% Confidence Interval [CI] 5.2-6.3%) of the older population in 1990-93 to 9.9% (9.3-10.7%) in 2008-11, adjusted odds ratio of 1.90 (95%CI 1.67 – 2.16). People with clinically significant cognitive impairment (MMSE [Mini Mental State Examination] 21 or less) were the heaviest users of potent anticholinergic in CFAS II (16.5% [95%CI 12.0-22.3%]). Large increases in the prevalence of the use medication with ‘any’ anticholinergic activity were seen in older people with clinically significant cognitive impairment (53.3% in CFAS I to 71.5% in CFAS II). Conclusions: Use of potent anticholinergic medications nearly doubled in England’s older population over 20 years with some of the greatest increases amongst those particularly vulnerable to anticholinergic side-effects.

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Increasing prevalence of anticholinergic medication use in older people in England over 20 years: Cognitive Function and Ageing Study I and II

10.21203/rs.2.17884/v2 ◽

2020 ◽

Author(s):

Carlota Grossi ◽

Kathryn Richardson ◽

George Savva ◽

Chris Fox ◽

Antony Arthur ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Older People ◽

Mental State ◽

Mini Mental State Examination ◽

Medication Use ◽

Anticholinergic Medication ◽

Older Population ◽

Clinically Significant ◽

State Examination

Abstract Background: Anticholinergic medication use is linked with increased cognitive decline, dementia, falls and mortality, and their use should be limited in older people. Here we estimate the prevalence of anticholinergic use in England’s older population in 1991 and 2011, and describe changes in use by participant’s age, sex, cognition and disability. Methods: We compared data from participants aged 65+ years from the Cognitive Function and Ageing Studies (CFAS I and II), collected during 1990-1993 (N=7,635) and 2008-2011 (N=7,762). We estimated the prevalence of potent anticholinergic use (Anticholinergic Cognitive Burden [ACB] score=3) and average anticholinergic burden (sum of ACB scores), using inverse probability weights standardised to the 2011 UK population. These were stratified by age, sex, Mini-Mental State Examination score, and activities of daily living (ADL) or instrumental ADL (IADL) disability. Results: Prevalence of potent anticholinergic use increased from 5.7% (95% Confidence Interval [CI] 5.2-6.3%) of the older population in 1990-93 to 9.9% (9.3-10.7%) in 2008-11, adjusted odds ratio of 1.90 (95%CI 1.67 – 2.16). People with clinically significant cognitive impairment (MMSE [Mini Mental State Examination] 21 or less) were the heaviest users of potent anticholinergic in CFAS II (16.5% [95%CI 12.0-22.3%]). Large increases in the prevalence of the use medication with ‘any’ anticholinergic activity were seen in older people with clinically significant cognitive impairment (53.3% in CFAS I to 71.5% in CFAS II). Conclusions: Use of potent anticholinergic medications nearly doubled in England’s older population over 20 years with some of the greatest increases amongst those particularly vulnerable to anticholinergic side-effects.

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Norms for the mini-mental state examination from a sample of Sri Lankan older people

International Journal of Geriatric Psychiatry ◽

10.1002/gps.2168 ◽

2009 ◽

Vol 24 (7) ◽

pp. 666-670 ◽

Cited By ~ 11

Author(s):

Ranil De Silva ◽

Sarada Disanayaka ◽

Nayomi De Zoysa ◽

Niluka Sanjeewanie ◽

S. Somaratne ◽

...

Keyword(s):

Older People ◽

Mental State ◽

Mini Mental State Examination ◽

Sri Lankan ◽

State Examination

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Physical and Psychical Conditions Decline of Older People With Age, Measured by Functional Reach Test and by Mini Mental State Examination

Volume 2: Automotive Systems; Bioengineering and Biomedical Technology; Computational Mechanics; Controls; Dynamical Systems ◽

10.1115/esda2008-59055 ◽

2008 ◽

Author(s):

Marianna Costarella ◽

Lucilla Monteleone ◽

Roberto Steindler ◽

Stefano Maria Zuccaro

Keyword(s):

Older People ◽

Mental State ◽

Cognitive Abilities ◽

Mini Mental State Examination ◽

Short Term Memory ◽

Temporal Orientation ◽

Functional Reach ◽

Functional Reach Test ◽

Physical Performances ◽

State Examination

There are several tests to value the psychophysical characteristics of older people and, among all, the most suitable to this aim are here considered the Functional Reach (FR) test, as an index of the aptitude to maintain balance in upright position, and the Mini Mental State Examination (MMSE), as a global index of cognitive abilities. The sample of older people we have analysed concerns 50 healthy subjects divided into three groups according to the age (15 from 55 to 64 years old, 19 from 65 to 74 years old, and 16 more than 75 years old); they underwent a FR test, which consists first in the measurement of the anthropometric characteristics, then in the execution of the test itself, and finally in the study of the upright posture carried out analysing the Centre of Pressure (COP) trend; they underwent as well a MMSE to value the main areas of the cognitive function concerning the space-temporal orientation, the short-term memory, the attention ability, the calculus ability and the praxis-constructive ability. The results of these tests show, according to the age, a loss both of the physical performances (FR, FR related to height, and COP displacement), and of the cognitive abilities (MMSE); however, in all cases, the only significant changes are those between the first and the other two groups of age. A comparison between the results of male and female subjects inside the three groups, although the results of the males are generally superior to the female ones, is never significant; moreover, the differences of the FR tests, in particular, are completely not significant if compared to the height of the subjects. Finally, a comparison between FR and MMSE shows a quicker decline of the physical performances with regard to the cognitive ones.

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Impact of sociodemographic and health variables on mini-mental state examination in a community-based sample of older people

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/s00406-010-0104-3 ◽

2010 ◽

Vol 260 (7) ◽

pp. 535-542 ◽

Cited By ~ 33

Author(s):

Camila Moraes ◽

Jony Arrais Pinto ◽

Marcos Antônio Lopes ◽

Julio Litvoc ◽

Cassio M. C. Bottino

Keyword(s):

Older People ◽

Mental State ◽

Mini Mental State Examination ◽

Community Based ◽

State Examination

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Mini-Mental-State

Zeitschrift für Gerontopsychologie & -psychiatrie ◽

10.1024/1011-6877.22.1.11 ◽

2009 ◽

Vol 22 (1) ◽

pp. 11-16 ◽

Cited By ~ 5

Author(s):

Andreas Kaiser ◽

Renate Gusner-Pfeiffer ◽

Hermann Griessenberger ◽

Bernhard Iglseder

Keyword(s):

Mental State ◽

Mini Mental State Examination ◽

Oder Nicht ◽

State Examination

Im folgenden Artikel werden fünf verschiedene Versionen der Mini-Mental-State-Examination dargestellt, die alle auf der Grundlage des Originals von Folstein erstellt wurden, sich jedoch deutlich voneinander unterscheiden und zu unterschiedlichen Ergebnissen kommen, unabhängig davon, ob das Screening von erfahrenen Untersuchern durchgeführt wird oder nicht. Besonders auffällig ist, dass Frauen die Aufgaben «Wort rückwärts» hoch signifikant besser lösten als das «Reihenrechnen». An Hand von Beispielen werden Punkteunterschiede aufgezeigt.

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Zur Anwendung der CES-D bei älteren Menschen: Dimensionsstruktur und Meßartefakte

Diagnostica ◽

10.1026//0012-1924.46.1.29 ◽

2000 ◽

Vol 46 (1) ◽

pp. 29-37 ◽

Cited By ~ 7

Author(s):

Herbert Matschinger ◽

Astrid Schork ◽

Steffi G. Riedel-Heller ◽

Matthias C. Angermeyer

Keyword(s):

Mental State ◽

Latent Class ◽

Mini Mental State Examination ◽

Depression Scale ◽

Epidemiological Studies ◽

Partial Credit ◽

Examination Score ◽

State Examination

Zusammenfassung. Beim Einsatz der Center for Epidemiological Studies Depression Scale (CES-D) stellt sich das Problem der Dimensionalität des Instruments, dessen Lösung durch die Konfundierung eines Teilkonstruktes (“Wohlbefinden”) mit Besonderheiten der Itemformulierung Schwierigkeiten bereitet, da Antwortartefakte zu erwarten sind. Dimensionsstruktur und Eignung der CES-D zur Erfassung der Depression bei älteren Menschen wurden an einer Stichprobe von 663 über 75-jährigen Teilnehmern der “Leipziger Langzeitstudie in der Altenbevölkerung” untersucht. Da sich die Annahme der Gültigkeit eines partial-credit-Rasch-Modells sowohl für die Gesamtstichprobe als auch für eine Teilpopulation als zu restriktiv erwies, wurde ein 3- bzw. 4-Klassen-latent-class-Modell für geordnete Kategorien berechnet und die 4-Klassen-Lösung als den Daten angemessen interpretiert: Drei Klassen zeigten sich im Sinne des Konstrukts “Depression” geordnet, eine Klasse enthielt jene Respondenten, deren Antwortmuster auf ein Antwortartefakt hinwiesen. In dieser Befragtenklasse wird der Depressionsgrad offensichtlich überschätzt. Zusammenhänge mit Alter und Mini-Mental-State-Examination-Score werden dargestellt. Nach unseren Ergebnissen muß die CES-D in einer Altenbevölkerung mit Vorsicht eingesetzt werden, der Summenscore sollte nicht verwendet werden.

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