What is a significant score change on the mini‐mental state examination?

The distribution of change scores of the Mini-Mental State Examination (MMSE) was assessed in healthy aged subjects after an interval of 1 year. As part of the Amsterdam Study of the Elderly, which is a community survey on ageing and cognitive decline (N = 4051; age range 65–84), a subsample of subjects (N = 247) was studied twice. Participants with dementia, other psychiatric disorders or physical disease which might interfere with cognitive testing were excluded. Test-retest reliability was 0.55 in this group. The distribution of change scores ranged from −9 to +5. From this result the following clinical rule-of-thumb was derived. In an individual patient, and in the absence of other indications of a dementing process, a deterioration in MMSE score must be greater than five points after 1 year to be suspect for a genuine cognitive decline.