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Journal of the International Neuropsychological Society : JINS
06, 2024;30 (5): 454-463.

Psychometric reliability, validity, and generalizability of 3MSE scores among American Indian adults: the Strong Heart Study.

Astrid M Suchy-Dicey, Thao T Vo, Kyra Oziel, Dedra S Buchwald, Lonnie A Nelson, Steven P Verney, Brian F French
Author Information
  1. Astrid M Suchy-Dicey: Huntington Medical Research Institutes, Pasadena, CA, USA. ORCID
  2. Thao T Vo: Washington State University, College of Education, Pullman, WA, USA.
  3. Kyra Oziel: Washington State University, Elson S Floyd College of Medicine, Seattle, WA, USA.
  4. Dedra S Buchwald: Washington State University, Elson S Floyd College of Medicine, Seattle, WA, USA.
  5. Lonnie A Nelson: Washington State University, College of Nursing, Spokane, WA, USA.
  6. Steven P Verney: University of New Mexico, Albuquerque, NM, USA. ORCID
  7. Brian F French: Washington State University, College of Education, Pullman, WA, USA.
PMID: 38263740 DOI: 10.1017/S1355617723011438

Abstract

OBJECTIVE: Modified Mini-Mental State Examination (3MSE) is often used to screen for dementia, but little is known about psychometric validity in American Indians.
METHODS: We recruited 818 American Indians aged 65-95 for 3MSE examinations in 2010-2013; 403 returned for a repeat examination in 2017-2019. Analyses included standard psychometrics inferences for interpretation, generalizability, and extrapolation: factor analysis; internal consistency-reliability; test-retest score stability; multiple indicator multiple cause structural equation models.
RESULTS: This cohort was mean age 73, majority female, mean 12 years education, and majority bilingual. The 4-factor and 2nd-order models fit best, with subfactors for orientation and visuo-construction (OVC), language and executive functioning (LEF), psychomotor and working memory (PMWM), verbal and episodic memory (VEM). Factor structure was supported for both research and clinical interpretation, and factor loadings were moderate to high. Scores were generally consistent over mean 7 years. Younger participants performed better in overall scores, but not in individual factors. Males performed better on OVC and LEF, females better on PMWM. Those with more education performed better on LEF and worse on OVC; the converse was true for bilinguals. All differences were significant, but small.
CONCLUSION: These findings support use of 3MSE for individual interpretation in clinic and research among American Indians, with moderate consistency, stability, reliability over time. Observed extrapolations across age, sex, education, and bilingual groups suggest some important contextual differences may exist.

Keywords

3MSE American Indian cognition health disparities neuropsychology psychometrics

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Grants

  1. L60 MD014438/NIMHD NIH HHS
  2. R01 HL093086/NHLBI NIH HHS
  3. P50 AG005136/NIA NIH HHS
  4. K01 AG057821/NIA NIH HHS
  5. P30 AG066509/NIA NIH HHS

MeSH Term

Humans
Male
Female
Aged
Psychometrics
Reproducibility of Results
Aged, 80 and over
Mental Status and Dementia Tests
American Indian or Alaska Native
Executive Function
Memory, Short-Term
Factor Analysis, Statistical
Dementia
Cognitive Dysfunction
Indians, North American
Journal Article Research Support, N.I.H., Extramural
Article has an altmetric score of 7

Word Cloud

Created with Highcharts 10.0.03MSEAmericanbetterIndiansinterpretationmeaneducationOVCLEFperformedvaliditypsychometricsgeneralizabilityfactorstabilitymultiplemodelsagemajorityyearsbilingualmemoryPMWMresearchmoderatescoresindividualdifferencesamongreliabilityIndianOBJECTIVE:ModifiedMini-MentalStateExaminationoftenusedscreendementialittleknownpsychometricMETHODS:recruited818aged65-95examinations2010-2013403returnedrepeatexamination2017-2019Analysesincludedstandardinferencesextrapolation:analysisinternalconsistency-reliabilitytest-retestscoreindicatorcausestructuralequationRESULTS:cohort73female124-factor2nd-orderfitbestsubfactorsorientationvisuo-constructionlanguageexecutivefunctioningpsychomotorworkingverbalepisodicVEMFactorstructuresupportedclinicalloadingshighScoresgenerallyconsistent7YoungerparticipantsoverallfactorsMalesfemalesworseconversetruebilingualssignificantsmallCONCLUSION:findingssupportuseclinicconsistencytimeObservedextrapolationsacrosssexgroupssuggestimportantcontextualmayexistPsychometricadults:StrongHeartStudycognitionhealthdisparitiesneuropsychology

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