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Factors associated with performance in the Mini Mental State Examination: a cross-sectional study

Clóris Regina Blanski Grden, July Hellen Linhares da Rocha, Luciane Patrícia Andreani Cabral, Jacy Aurélia Vieira de Sousa, Péricles Martim Reche, Pollyanna Kássia de Oliveira Borges


Aim: to identify the factors associated with performance in the Mini Mental  State  Examination  (MMSE)  on  the  part  of  the  elderly  attending  a  specialized outpatient  clinic.  Method:  a  cross-sectional  study  involving  a  convenience  sample, comprising 216 elderly people waiting for consultation at a specialized outpatient clinic, from March to June 2015, with the application of a structured instrument and the MMSE. For  analysis  purposes,  the  study  made  use  of  Stata  version  12  software,  and  results were considered statistically significant when p<0.05. Results: subjects who were female (54%), married (44%), who lived with their spouse (41%) and had low educational level (70%)  characteristics  predominated.  We  identified  a  significant association  between MMSE  performance  and  gender  (p=0.001),  education  (p=0.001),  income  (p=0.001), home  companions  (p=0.002)  and  individual  monthly  income  (p=0.001).  Conclusion: early identification of cognitive decline and associated factors enables prevention and/or treatment strategies to be implemented by health professionals, especially nurses.


Nursing; Mini Mental State Exam; Cognitive Decline; Outpatient Clinic.


Cruz DT, Cruz FM, Ribeiro AL, Veiga CL, Leite ICG. Association between cognitive ability and the occurrence of falls in elderly. Cad Saúde Colet [internet]. 2015 [Cited 2016 Jan 16]; 23(4): 386-93. Available from:

Andrade NB, Novelli MMPC. Perfil cognitivo e funcional de idosos frequentadores dos Centros de Convivência para idosos da cidade de Santos, SP. Cad Ter Ocup UFSCar [internet]. 2015 [Cited 2016 Fev 6]; 23(1):143-152. Available from:

Holz AW, Nunes BP, Thumé E, Lange C, Facchini LA. Prevalence of cognitive impairment and associated factors among the elderly in Bagé, Rio Grande do Sul, Brazil. Rev Bras Epidemiol [internet]. 2013 [Cited 2015 Nov 10]; 16(4):880-8. Available from:

Vogel A, Salem LC, Andersen BB, Waldemar G. Differences in quantitative methods for measuring subjective cognitive decline - results from a prospective memory clinic study. Int Psychogeriatr [internet]. 2016 [Cited 2016 Jun 10]; 7:1-8. Available from:

Miu J, Negin J, Salinas-Rodriguez A, Manrique-Espinoza B, Sosa-Ortiz AL, Cumming R, Kowal P, et al. Factors associated with cognitive function in older adults in Mexico. Glob Health Action [internet]. 2016 [Cited 2016 Jun 10]; 9: 30747. Available from:

Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. [internet]. 2013 [Cited 2015 Nov 20]; 9:63–75.e2. Available from:

Ferreira LS, Pinho MSP, Pereira MWM, Ferreira AP. Cognitive profile of elderly residents in Long-stay Institutions of Brasilia-DF. Rev Bras Enferm [internet]. 2014 [Cited 2016 Fev 20]; 67(2):247-51. Available from:

Melo DM, Barbosa AJG. Use of the Mini-Mental State Examination in research on the elderly in Brazil: a systematic review. Ciência & Saúde Coletiva [internet]. 2015 [Cited 2016 Fev 10];20(12):3865-76. Available from:

Bertoldi JT, Batista AC, Ruzanowsky S. Cognitive impairment on institucionalized elderly: a literature review. Cinergis [internet]. 2015 [Cited 2016 Mar 10];16(2):152-156. Available from:

Langa KM, Levine DA. The Diagnosis and Management of Mild Cognitive Impairment: A Clinical Review. JAMA [internet]. 2014 [Cited 2015 Jan 13]; 312(23): 2551–2561. Available from:

Nascimento RAS, Batista RTS, Rocha SV, Vasconcelos LRC. Prevalência e fatores associados ao declínio cognitivo em idosos com baixa condição econômica: estudo MONIDI. J Bras Psiquiatr [internet]. 2015 [Cited 2016 Jan 13];64(3):187-92. Available from:

Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. The Mini-Mental State Examination in a general population: impact of educational status. Arq Neuropsiquiatr [internet]. 1994 [Cited 2015 Nov 13]; 52(1):1-7. Available from:

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for granding the cognitive state of patients for the clinican. J Psychiatr Res [internet]. 1975 [Cited 2015 Nov 13]; 12(3):189-98. Available from:

Cunha FCM, Cintra MTG, Dornelas JM, Assis MG, Cassiano JG, Nicolato R, et al. Declínio funcional em idosos com comprometimento cognitivo leve. Rev Med Minas Gerais [internet]. 2015 [Cited 2016 Fev 13]; 25(3): 423-431. Available from:

Danielewicz AL,Wagner KJP, d’Orsi E, Boing AF. Is cognitive decline in the elderly associated with contextual income? Results of a population-based study in southern Brazil. Cad Saúde Pública [internet]. 2016 [Cited 2016 Jun 13];32(5):e00112715. Available from:

Domiciano BR, Braga DKAP, Silva PN, Vasconcelos TB, Macena RHM. Escolaridade, idade e perdas cognitivas de idosas residentes em instituições de longa permanência. Rev Neurocienc Pública [internet]. 2014 [Cited 2015 Nov 13]; 22(3):330-6. Available from:

Araújo CCR, Silveira C, Simas JPN, Zappelini A, Parcias SR, Guimarães ACA. Aspectos cognitivos e nível de atividade física de idosos. Saúde (Santa Maria), Santa Maria [internet]. 2015 [Cited 2016 Mar 13]; 41(2):193-202. Available from:

Ho V, Zainal H, Lim L, Ng A, Silva NG, Kandi N. Voluntary cognitive screening: characteristics of participants in an Asian setting. Clinical Interventions in Aging [internet]. 2015 [Cited 2016 Jan 3]; 10:771–780. Available from:

Neri AL, Yassuda MA, Araújo LF, Eulálio MC, Cabral BE, Siqueira MEC, et. al. Methodology and social, demographic, cognitive, and frailty profiles of community-dwelling elderly from seven Brazilian cities: the FIBRA Study. Cad Saúde Pública [internet]. 2013 [Cited 2015 Nov 15]; 29(4):778–92. Available from:

Wee LE, Yeo WX, Yang GR, Hannan N, Lim K, Chua C, et al. Individual and area level socioeconomic status and its association with cognitive function and cognitive impairment (low MMSE) among community-dwelling elderly in Singapore. Dement Geriatr Cogn Disord Extra [internet]. 2012 [Cited 2015 Nov 15]; 2:529-42. Available from: