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Population-Based Norms for the Mini-Mental State Examination by Age and Educational Level
Rosa M. Crum. JAMA, 1993-05-12
Topic: Risk, prevention and care in population studies
OBJECTIVE: To report the distribution of Mini-Mental State Examination (MMSE) scores by age and educational level. DESIGN: National Institute of Mental Health Epidemiologic Catchment Area Program surveys conducted between 1980 and 1984. SETTING: Community populations in New Haven, Conn; Baltimore, Md; St Louis, Mo; Durham, NC; and Los Angeles, Calif. PARTICIPANTS: A total of 18,056 adult participants selected by probability sampling within census tracts and households. MAIN OUTCOME MEASURES: Summary scores for the MMSE are given in the form of mean, median, and percentile distributions specific for age and educational level. RESULTS: The MMSE scores were related to both age and educational level. There was an inverse relationship between MMSE scores and age, ranging from a median of 29 for those 18 to 24 years of age, to 25 for individuals 80 years of age and older. The median MMSE score was 29 for individuals with at least 9 years of schooling, 26 for those with 5 to 8 years of schooling, and 22 for those with 0 to 4 years of schooling. CONCLUSIONS: Cognitive performance as measured by the MMSE varies within the population by age and education. The cause of this variation has yet to be determined. Mini-Mental State Examination scores should be used to identify current cognitive difficulties and not to make formal diagnoses. The results presented should prove to be useful to clinicians who wish to compare an individual patient's MMSE scores with a population reference group and to researchers making plans for new studies in which cognitive status is a variable of interest.
Why it matters
Reports typical Mini-Mental State Examination scores by age and education from 18,056 adults in US community surveys. Scores were lower with older age and fewer years of schooling, from a median of 29 at ages 18 to 24 to 25 at age 80 and older. The authors say MMSE scores should flag current cognitive difficulties, not be used to make formal diagnoses.
How this study scored 56/100
Published in a top-tier journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on strength of evidence, so that was left out: it earned 53 of the 95 points we could judge it on, which is 56 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (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 | — / 5 | No evidence rating recorded — left out of this score |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1993 — 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 | 7 / 7 | Cited 2,860 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 81.7 citations a year over 35 year(s) since 1993 |
| Impact for its field and year | 5 / 6 | Cited 21.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 4 / 4 | Cited 204 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Rosa M. Crum: h-index 58 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (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 8479064) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 53 / 95 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 53 of the 95 points we could judge it on is 56 out of 100. |
| Total | 56 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Crum, R. M. (1993). Population-Based Norms for the Mini-Mental State Examination by Age and Educational Level. JAMA. https://doi.org/10.1001/jama.1993.03500180078038
Vancouver
Crum RM. Population-Based Norms for the Mini-Mental State Examination by Age and Educational Level. JAMA. 1993. doi:10.1001/jama.1993.03500180078038. PMID: 8479064.
BibTeX
@article{crum1993-8479064,
author = {Crum, Rosa M.},
title = {{Population-Based Norms for the Mini-Mental State Examination by Age and Educational Level}},
journal = {JAMA},
year = {1993},
doi = {10.1001/jama.1993.03500180078038},
pmid = {8479064},
url = {https://doi.org/10.1001/jama.1993.03500180078038}
}