Using Mini-Mental State Examination to screen for cognitive functioning failures in older people: limitations of the so called Mungas correction in assessing deficits

Introduction
To screen for cognitive functioning failures using the Mini-Mental State Examination (MMSE) adjusting for participant’s age and years of schooling by means of Mungas correction.

Material and methods
There were 386 participants, including 302 women and 84 men, who were tested using the MMSE screening test. First, the correlation between the test results and age as well as the total years of schooling was explored, then the raw test results were adjusted by means of the Mungas correction.

Results
There is a statistically significant negative correlation between participants’ age and the MMSE test results (r = –0.494, p = 0.0000). Also, the research revealed a statistically significant positive correlation between the total years of schooling and MMSE test results (r = 0.324, p = 0.0000). Once Mungas correction was implemented, no correlation between age and the adjusted MMSE test results was found (r = 0.0704, p = 0.1671). In contrast, there appeared a negative correlation between MMSE test results and the total years of schooling (r = –0.1422, p < 0.01).

Conclusions
The research shows that as age increased the MMSE test results decreased. In contrast, the MMSE test results increased as the total years of schooling increased. The implemented Mungas correction caused apparent false correlations whereby an increase in test score correlated with higher age, whereas a decrease in score corelated with more years of schooling. The use of the said screening procedure requires caution so as to avert incorrect diagnostic and therapeutic decisions in clinical practice.