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Performance on the Mini-Mental State Examination and Mattis Dementia Rating Scale Among Older American Indians

Received December 7, 2005; revised May 26, 2006; accepted June 5, 2006. Drs. Jervis and Beals and Ms. Fickenscher are affiliated with the American Indian and Alaska Native Programs, Department of Psychiatry, University of Colorado at Denver and Health Sciences Center School of Medicine, Denver, Colorado. Dr. Arciniegas is affiliated with Neuropsychiatry Service, Department of Psychiatry, and the Behavioral Neurology Section, Department of Neurology, University of Colorado at Denver and Health Sciences Center School of Medicine, Denver, Colorado. Address correspondence to Dr. Jervis, Nighthorse Campbell Native Health Building, P.O. Box 6508, Mail Stop F800, Aurora, CO 80045; Lori.Jervis{at}UCHSC.edu (e-mail).

Optimal methods for assessing cognitive impairment among older American Indians have not been established. This study sought to examine the cultural relevance and performance of two common cognitive screening measures, the Mini-Mental State Examination (MMSE) and Mattis Dementia Rating Scale (MDRS), in one American Indian population. One hundred forty American Indians ages 60 to 89 were assessed; nearly 11% scored more than 2 standard deviation points below performance expectations on the MMSE, as did 27% to 81% on the MDRS. Complex relationships were found between gender, health conditions (with possible effects on cognitive functioning), and MMSE and MDRS scores. The authors discuss implications and future directions.

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