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Coordinated analysis of age, sex, and education effects on change in MMSE scores

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  • Andrea M. Piccinin
  • Graciela Muniz-Terrera
  • Sean Clouston
  • Chandra A. Reynolds
  • Valgeir Thorvaldsson
  • Ian J. Deary
  • Dorly J. H. Deeg
  • Boo Johansson
  • Andrew Mackinnon
  • Avron Spiro
  • John M. Starr
  • Ingmar Skoog
  • Scott M. Hofer

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    Rights statement: © Coordinated Analysis of Age, Sex, and Education Effects on Change in MMSE Scores. / Piccinin, Andrea M.; Muniz-Terrera, Graciela; Clouston, Sean; Reynolds, Chandra A.; Thorvaldsson, Valgeir; Deary, Ian J.; Deeg, Dorly J. H.; Johansson, Boo; Mackinnon, Andrew; Spiro, Avron; Starr, John M.; Skoog, Ingmar; Hofer, Scott M. In: Journals of Gerontology - Series B Psychological Sciences and Social Sciences, Vol. 68, No. 3, 05.2013, p. 374-390. DOI 10.1093/geronb/gbs077

    Accepted author manuscript, 384 KB, PDF document

Original languageEnglish
Pages (from-to)374-390
Number of pages17
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Issue number3
Early online date2 Oct 2012
Publication statusPublished - May 2013


We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline.

Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point.

Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time.

A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ.

    Research areas

  • cognitive, coordinated analysis, education, longitudinal, mental status exam, meta-analysis, mixed model, mini mental state, 6 year follow-up, cognitive decline, alzheimers disease, old age, reserve hypothesis, processing speed, dementia, people, health

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