Journals of Gerontology Series B: Psychological Sciences and Social Sciences
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]
Author:
Keyword(s):
Year:  Vol:  Page: 


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Cited by other online articles
Google Scholar
Right arrow Articles by Jones, R. N.
Right arrow Articles by Gallo, J. J.
Right arrow Articles citing this Article
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jones, R. N.
Right arrow Articles by Gallo, J. J.
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 57:P548-P558 (2002)
© 2002 The Gerontological Society of America


RESEARCH ARTICLE

Education and Sex Differences in the Mini-Mental State Examination

Effects of Differential Item Functioning

Richard N. Jones1 and Joseph J. Gallo2

1 Hebrew Rehabilitation Center for Aged Research and Training Institute, Boston, Massachusetts.
2 Department of Family Practice and Community Medicine, University of Pennsylvania, Philadelphia.

Address correspondence to Richard N. Jones, ScD, HRCA Research and Training Institute, 1200 Centre Street, Boston, MA 02131. E-mail: jones{at}mail.hrca.harvard.edu

Years of completed education is a powerful correlate of performance on mental status assessment. This analysis evaluates differences in cognitive performance attributable to level of education and sex. We analyzed Mini-Mental State Examination responses from a large community sample (Epidemiologic Catchment Area study, N = 8,556), using a structural equation analytic framework grounded in item response theory. Significant sex and education group differential item functioning (DIF) were detected. Those with low education were more likely to err on the first serial subtraction, spell world backwards, repeat phrase, write, name season, and copy design tasks. Women were more likely to err on all serial subtractions, men on spelling and other language tasks. The magnitude of detected DIF was small. Our analyses show that failing to account for DIF results in an approximately 1.6% overestimation of the magnitude of difference in assessed cognition between high- and low-education groups. In contrast, nearly all (95%) of apparent sex differences underlying cognitive impairment are due to DIF. Therefore, item bias does not appear to be a major source of observed differences in cognitive status by educational attainment. Adjustments of total scores that eliminate education group differences are not supported by these results. Our results have implications for future research concerning education and risk for dementia.




This article has been cited by other articles: (Search Google Scholar for Other Citing Articles)


Home page
Ann Intern MedHome page
C. A. McHorney
Ten Recommendations for Advancing Patient-Centered Outcomes Measurement for Older Persons
Ann Intern Med, September 2, 2003; 139(5_Part_2): 403 - 409.
[Abstract] [Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
All GSA journals The Gerontologist
Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Copyright © 2002 by The Gerontological Society of America.