MMSE Mini Mental

Spmsq And Mmse

Presence of cognitive impairment was identified in 83.6% of patients.

Female patients have a significantly higher MMSE score than male patients.

Patients with high education level have a significantly higher MMSE score.

Patients with youth-onset schizophrenia have a significantly lower MMSE score.

Longer length of hospital stay indicated a significantly lower MMSE score.

Studies have found that age and education were associated with cognition in older adults. However, little is known how clinical factors (e.g. age of illness onset, length of hospital stay, type of antipsychotic medications, and duration of illness) are associated with cognitive functioning in patients with schizophrenia. This study aimed to examine the influence of socio-demographic and clinical factors on cognitive domains measured using Mini-Mental State Examination (MMSE) among patients with schizophrenia or schizoaffective disorders residing in a psychiatric institute in Singapore. A single-phase interview was conducted at the Institute of Mental Health (IMH) in patients diagnosed with schizophrenia or schizoaffective disorders (n=110). MMSE was administered to all participants. Data on socio-demographic characteristics, smoking, alcohol consumption, and medical history were collected. Age, gender, and level of education were significantly associated with MMSE scores. After adjusting for all socio-demographic correlates, longer length of hospital stay remained significant in predicting lower MMSE scores. Length of hospital stay was independently associated with cognitive functioning. Early interventions for cognition such as physical and mental exercises should be implemented for better prognosis.

Keywords

  • Cognitive impairment;
  • Age of onset;
  • Length of hospital stay;
  • Antipsychotics;
  • Duration of illness;
  • Deinstitutionalisation;
  • Singapore

1. Introduction

Cognitive impairment is one of the key problems in patients with schizophrenia. Studies have found that patients with schizophrenia have more cognitive deficits than healthy individuals even in the early stages of psychotic illness ( and ). Magnetic resonance imaging (MRI) studies have found significant decrease in cerebral grey matter volume, cortical volume, and thickness in patients with schizophrenia than healthy controls participants and postulated that these could lead to the cognitive decline. The cognitive deficits include domains of executive attention, working memory, verbal skills, executive functioning, and speed of processing. A review conducted by reported that these neurocognitive deficits would affect an individual's functional status across different outcome domains (i. e. self-care, independent living, social and interpersonal functioning, vocational functioning etc.).

Mini-Mental State Examination (MMSE) is a brief measure of global cognition and is often used for evaluation of cognitive functioning. This instrument was developed by to assess five domains of cognition: orientation with regard to time and place, registration of words, attention and calculation, recall, and language. It is a validated and effective screening tool for cognitive impairment among elderly, community dwelling, institutionalized, and hospitalized adults.

Studies conducted in different populations found that MMSE scores were influenced by socio-demographic factors such as age and education in Portuguese healthy adults and ethnic differences in Singapore community-living elderly population. Age and level of education were two prominent socio-demographic factors associated with MMSE in patients with schizophrenia and gender differences were also found in cognitive performance among older adults in Korea. Younger age and higher education level were found to be associated with better MMSE scores, whereas females had more cognitive impairment. Education was found to be the best predictor of MMSE scores, followed by age and gender in elderly Koreans.

Other factors such as heavy smoking and alcohol consumption were also associated with cognitive impairment assessed using other cognitive tests. Studies suggest that smoking has a negative influence on cognition and the brain. Similarly among alcohol dependent patients, deficits in the visual episodic memory, slower reaction time, and reduced working memory span have been reported compared to healthy controls.

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