Age-Normative MMSE Data for Older Persons Aged 85 to 93 in a Longitudinal Swedish Cohort

BACKGROUND/OBJECTIVES: Normative Mini-mental state examination (MMSE) reference values in elderly are scarce. Therefore, the aim is to present normative MMSE values for 85-93 year olds. DESIGN: A longitudinal age cohort study. SETTING: A population study of the residents in the municipality of Linköping, Sweden. PARTICIPANTS: Residents (n = 650) born in 1922 during the course of 2007. In total, 374 individuals participated and were tested with MMSE at age 85, 280 of these were willing and able to also participate at age 86, 107 at age 90 and 51 at age 93. MEASUREMENTS: MMSE, from 0-30, with lower scores denoting more impaired cognition. RESULTS: Median MMSE values for the total population over the ages 85, 86, 90 and 93 years was 28 for all ages investigated. The 25th percentile values were 26, 26, 26 and 27, respectively. For a "brain healthy" sub-group median values were 28, 29, 28, and 28. The 25th percentile values were 27, 28, 26 and 27, respectively. Comparisons for age-effects showed no differences when all individuals for each age group were compared. When only the individuals reaching 93 years of age (n = 50) were analyzed, there was a significant lowering of MMSE in that age group. CONCLUSION: The literature is variable and in clinical practice a low (24) MMSE cut off is often used for possible cognitive impairment in old age. The present data indicate that MMSE 26 is a reasonable cut off for possible cognitive decline in older persons up to the age of 93. J Am Geriatr Soc 67:534-538, 2019