Formal education, health literacy and Mini-Mental State Examination

Abstract The Mini-Mental State Examination (MMSE) is a widely used screening test for cognitive impairment, but is heavily biased by education. Educational level has frequently been ranked using years of schooling, which may not be a good indirect measure of educational level because there is great heterogeneity in standards of schooling among populations and across regions of the same country. S-TOFHLA is a measure of health literacy with some results indicating that it is a good measure for literacy level. Objective: To evaluate the correlations between years of schooling and scores on the S-TOFHLA and the MMSE. Methods: Healthy subjects without cognitive impairment were submitted to the S-TOFHLA and the MMSE. Correlations and regression analysis were performed to determine possible associations among variables. Results: Both years of schooling and S-TOFHLA scores were strongly correlated with MMSE scores, but the strongest association was reached by the S-TOFHLA (r=0.702, p<0.01), where the S-TOFHLA was the best predictor of MMSE scores (R2=0.494, p<0.001). Conclusions: A stronger association between S-TOFHLA scores and MMSE performance was found than between years of education and MMSE scores. This finding justifies further studies incorporating years of schooling together with S-TOFHLA score, to evaluate cognitive performance.

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Bibliographic Details
Main Authors: Brucki,Sonia Maria Dozzi, Mansur,Letícia Lessa, Carthery-Goulart,Maria Teresa, Nitrini,Ricardo
Format: Digital revista
Language:English
Published: Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento 2011
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642011000100026
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