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Correlation between age and MMSE in schizophrenia

Published online by Cambridge University Press:  15 April 2015

Jean-Robert Maltais ,
Geneviève Gagnon ,
Marie-Pierre Garant  and
Jean-François Trudel
Jean-Robert Maltais*
Affiliation:
Centre de Santé et de Services Sociaux, Institut Universitaire de Gériatrie de Sherbrooke, University of Sherbrooke, Quebec, Canada
Geneviève Gagnon
Affiliation:
Department of Geriatric Psychiatry, Douglas Mental Health University Institute, Montreal, Quebec, Canada
Marie-Pierre Garant
Affiliation:
Centre de Recherche du CHUS, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
Jean-François Trudel
Affiliation:
Centre de Santé et de Services Sociaux, Institut Universitaire de Gériatrie de Sherbrooke, University of Sherbrooke, Quebec, Canada
*
Correspondence should be addressed to: Dr Jean-Robert Maltais, MD, FRCPC, CSSS – IUGS, 375 Argyll, Sherbrooke (Quebec), J1J 3H5, Canada. Phone: +1(819) 821-5103; Fax: +1(819) 829-7137. Email: jean-robert.maltais@usherbrooke.ca.
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Abstract

Background:

The Mini-Mental State Examination (MMSE) is widely used in schizophrenia, although normative data are lacking in this population. This review and meta-regression analysis studies the effect of aging on MMSE scores in schizophrenic patients.

Methods:

We entered the search terms schizophrenia and MMSE in PubMed and PsychInfo. Bibliographies of pertinent articles were also examined. We included every study presenting the MMSE scores in schizophrenic patients along with a corresponding mean age. We conducted our analyses using simple linear regression weighted for the inverse of within-trial variance of the age variable, thus conferring more importance to studies with narrower age groups.

Results:

We identified 56 articles (n = 5,588) published between 1990 and 2012. The MMSE scores of schizophrenic patients decline by approximately 1 point for every four years (y = 34.939−0.247x, 95% Confidence Interval (CI) [−0.304, −0.189], R2 = 0,545), which is five times the rate in the general population. Institutionalized patients account for a large proportion of this decline (y = 37.603–0.308x, 95% CI [−0.349, −0.267], R2 = 0.622) whereas community-dwelling patients are relatively stable throughout aging (y = 27.591–0.026x, 95% CI [−0.074, 0.023], R2 = 0.037).

Conclusions:

Subgroup analyses show different trajectories between institutionalized and outpatients with schizophrenia. The deterioration observed in institutionalized patients may have to do with greater illness severity, heavier medication load, vascular risk factors, and lack of stimulation in institutional settings. Studies documenting the role of these variables would be useful. Cognitive screening tools that assess executive functions would be interesting to study in schizophrenics, as they may reveal more subtle age-related cognitive changes not measured by the MMSE.

Keywords

Mini-Mental State Examinationschizophreniacognition (neuro-cognitive functions)agingreview
Type
Review Article
Information
International Psychogeriatrics , Volume 27 , Issue 11 , November 2015 , pp. 1769 - 1775
Copyright
Copyright © International Psychogeriatric Association 2015 

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