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Effect of education on the mini-mental state examination as a screening test for dementia
Uhlmann RF, Larson EB.. Journal of the American Geriatrics Society, 1991-09-01
Topic: Risk, prevention and care in population studies
We studied whether Mini-Mental State Examination (MMSE) norms for detecting dementia in elderly outpatients vary according to educational attainment. Subjects were 109 elderly outpatients with Alzheimer's dementia and 100 non-demented outpatient controls. Receiver operating characteristics (ROC) of the MMSE were examined among three strata of educational attainment: middle school, high school, and college/graduate school.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Uhlmann, R. F., & Larson, E. B. (1991). Effect of education on the mini-mental state examination as a screening test for dementia. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.1991.tb04454.x
Vancouver
Uhlmann RF, Larson EB. Effect of education on the mini-mental state examination as a screening test for dementia. Journal of the American Geriatrics Society. 1991. doi:10.1111/j.1532-5415.1991.tb04454.x. PMID: 1885862.
BibTeX
@article{uhlmann1991-1885862,
author = {Uhlmann, R. F. and Larson, E. B.},
title = {{Effect of education on the mini-mental state examination as a screening test for dementia}},
journal = {Journal of the American Geriatrics Society},
year = {1991},
doi = {10.1111/j.1532-5415.1991.tb04454.x},
pmid = {1885862},
url = {https://doi.org/10.1111/j.1532-5415.1991.tb04454.x}
}
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Key findings
- Subjects were 109 elderly outpatients with Alzheimer's dementia and 100 non-demented outpatient controls.
- Receiver operating characteristics (ROC) of the MMSE were examined among three strata of educational attainment: middle school, high school, and college/graduate school.
- MMSE ROC curve areas were .95-.96 in the three educational strata.
- Assuming a dementia prevalence of 10%-30%, the most accurate lower limits of normal for MMSE scores and their attendant sensitivities and specificities were 21 for middle school (.82/.94), 23 for high school (.79/.97), and 24 for college/graduate school (.83/1.00) attainment.
Why it matters
This study examined whether the MMSE's accuracy for detecting dementia in elderly outpatients varies with educational attainment across 109 Alzheimer's patients and 100 controls. It is about how education affects a screening test's performance, not about treating, curing or preventing Alzheimer's disease.
Study details
- Evidence strengthLow
How this study scored 45/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1991 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 252 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.8 citations a year over 37 year(s) since 1991 |
| Impact for its field and year | 3 / 6 | Cited 5.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 15 other studies in this library |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Eric B. Larson: h-index 105 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 1885862) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 45 / 100 | — |
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