Arq Neuropsiquiatr 2004;62(2-A):206-211 THE ROLE OF EDUCATION IN MINI-MENTAL STATE EXAMINATION

ABSTRACT- Background: There is evidence that schooling can influence performance in cognitive assessement tests. In develop-ing countries, formal education is limited for most people. The use of tests such as Mini-Mental State Examination (MMSE), could have an adverse effect on the evaluation of illiterate and low education individuals. Objective: To propose a new version of MMSE as a screening test to assess Illiterate and low education people. Method: A study was carried out enrolling 232 individuals, aged 60 or more of low and middle socio-economic classes. Three groups were studied: Illiterate;1-4 schooling years; 5-8 schooling years. The new version (MMSE-mo) consisted of modifications in copy and calculation items of the adapted MMSE (MMSE-ad) to Portuguese language.The maximum possible score was the same in the two versions: total, 30; copy, 1 and calculation, 5. Results: In the total test score ANOVA detected main effects for education and test, as well as an interaction between these factors: high-er schooling individuals performed better than lower schooling ones in both test versions; scores in MMSE-mo were higher than in MMSE-ad in every schooling group. Conclusion. Higher schooling levels improve the perfomance in both test versions, the copy and calculation items contributing to this improvement. This might depend on cultural factors. The use of MMSE-mo in illiterate and low school individuals could prevent false positive and false negative cognitive evaluations. KEY WORDS: mini-mental state examination, cognition, education, cognitive assessement. O papel da educação no mini exame do estado mental: um estudo no Nordeste do Brasil RESUMO- Contexto: Existem evidências de que a escolaridade pode influenciar o desempenho em testes de avaliação cognitiva. J