Selective memory impairment on an adapted Mini-Mental State Examination increases risk of future dementia

Int J Geriatr Psychiatry. 2004 Dec;19(12):1173-80. doi: 10.1002/gps.1236.


Objective: To determine whether selective memory impairment (SMI) on an adapted Mini-Mental State Examination (aMMSE) test increases risk of future dementia in a population-based survey of central Spain.

Background: SMI is a strong predictor of dementia in the elderly. However, most approaches have used extensive memory batteries, which are not always suitable for screening purposes.

Methods: The basal cohort consisted of 2982 poorly educated individuals aged 65 or over. Dementia, stroke and parkinsonism cases were previously excluded. At entry, participants received a structured interview including an aMMSE. Two groups were created according to basal cognitive performance, namely: (1) aMMSE > 23 and no word remembered on the aMMSE delayed-recall task (SMI group); and (2) aMMSE > 23 and at least one word remembered on the delayed-recall task (control group). In a three-year follow-up wave, conversion rate to dementia was calculated and logistic regression was performed.

Results: Of a total of 2507 subjects who completed the two evaluations, 280 qualified for SMI at entry. In the SMI group, 25 subjects (8.9%) developed dementia vs 26 subjects (1.2%) in the control group. Taking the two groups together, and once demographic and medical variables had been controlled, a low delayed-recall score increased dementia conversion rate (OR 0.47, 95% CI 0.34-0.64). Alzheimer's disease was the main cause of dementia (79.8%).

Conclusions: Memory impairment is a risk factor for future dementia in the neurologically-healthy elderly. This can be observed in a subgroup of subjects with SMI defined on the aMMSE delayed-recall subscore. Some other measurements should be added to the SMI construct to improve its predictive validity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alzheimer Disease / etiology
  • Alzheimer Disease / psychology
  • Cognition
  • Cognition Disorders / complications
  • Cognition Disorders / psychology
  • Cohort Studies
  • Dementia / etiology*
  • Dementia / psychology
  • Female
  • Humans
  • Male
  • Memory Disorders / complications*
  • Memory Disorders / psychology
  • Population Surveillance / methods
  • Prognosis
  • Psychological Tests
  • Risk Factors