Assessing cognitive ability in research: use of MMSE with minority populations and elderly adults with low education levels.

The Mini-Mental State Examination (MMSE), originally designed to screen for dementia, is an instrument currently used extensively to assess cognitive status in clinical and community settings. This descriptive study compares standard MMSE scores to MMSE scores adjusted for age and education in a sample of 414 elderly Black and White women living independently in communities. After scores were adjusted, 14 participants (all Black) were moved from categories of mild cognitive impairment to unimpaired cognitive ability. However, even after scores were adjusted for age and education, White elderly adults still had higher mean scores than Black elderly adults (p = .003), suggesting that racial differences may have an effect on MMSE performance independent of age and education. Further research is needed to better understand the interaction of race and culture on MMSE outcomes. Implications are offered for appropriate use of the MMSE considering factors of age, education, and racial differences to guide evidence-based practice by gerontological nurses engaged in work with elderly populations.