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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.4 no.2 São Paulo Apr./June 2010

http://dx.doi.org/10.1590/S1980-57642010DN40200008 

Original Articles

Mini- Mental State Examination among lower educationl levels and illiterates: transcultural evaluation

Mini-Exame do Estado Mental na baixa escolaridade e em analfabetos: avaliação transcultural

Sonia Maria Dozzi Brucki1 

Ricardo Nitrini1 

1MD, Behavioral and Cognitive Neurology Unit, Department of Neurology, University of São Paulo School of Medicine, São Paulo SP, Brazil.

Abstract

Cognitive performance among illiterates and low educational levels is poorer than that observed in individuals with greater schooling. This difference can be a confounding factor in reaching an accurate diagnosis of cognitive impairment. In addition, there is great heterogeneity in performance among illiterates, probably due to different environmental demands and sociocultural backgrounds. Many reports have described the influence of education on neuropsychological measures and screening tests such as the Mini-Mental State Examination (MMSE).

Objectives:

To analyze performance in two samples with the same educational level, but different social and cultural backgrounds.

Methods:

Subjects from two different locations in Brazil (rural sample from Northern region and urban sample residing in the largest city of the Southeastern region) were matched for age and education, and submitted to the MMSE.

Results:

Significant differences between the groups were found in total scores on the MMSE and in temporal orientation and serial-sevens sub-items for which the urban sample performed best but analysis of illiterates alone yielded the same results, except for the copying pentagons task which was performed better by the rural sample.

Conclusions:

Cultural and social backgrounds, as well as demands from the environment, influence results of screening tests. Factors other than education must be taken into account when analyzing tests.

Key words: Mini-Mental State Examination; illiteracy; educational level; screening test.

Resumo

O desempenho cognitivo entre iletrados e indivíduos com baixos níveis de escolaridade é pior do que observado entre indivíduos bem escolarizados. Esta diferença pode ser um fator de confusão quando um diagnóstico preciso de comprometimento cognitivo se faz necessário. Além disto, há uma grande heterogeneidade no desempenho destas pessoas, provavelmente devido a diferentes demandas ambientais, e base sociocultural. Muitos estudos tem descrito a influência educacional em medidas neuropsicológicas, bem como em testes de rastreio, como o Mini-Exame do Estado Mental (MEEM).

Objetivos:

Analisar o desempenho de duas amostras de mesmo nível educacional e diferentes bases sociais e culturais.

Métodos:

Indivíduos de dois locais no Brasil foram submetidos ao MEEM, pareados por idade e escolaridade.

Resultados:

Houve diferença significativa entre as amostras quanto ao escore total e sub-itens de orientação temporal e sete-seriados, com melhor desempenho para a amostra urbana, mas quando analisados somente os analfabetos, os mesmos resultados foram observados, exceto para a cópia dos pentágonos, onde a população rural teve desempenho melhor.

Conclusões:

A base social e cultural além das demandas do meio ambiente influenciam nos testes de rastreio. Outros fatores, além da educação, devem ser revistos quando analisarmos os testes.

Palavras-chave: Mini-Exame do Estado Mental; analfabetismo; nível educacional; teste de rastreio.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

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Received: January 19, 2009; Accepted: March 20, 2010

Sonia MD Brucki - Rua Rio Grande 180 / 61 - 04018-000 São Paulo SP - Brazil. E-mail: sbrucki@uol.com.br

Disclosure: The authors report no conflicts of interest.

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