Cognitive impairment using education-based cutoff points for CMMSE scores in elderly Chinese people of agricultural and rural Shanghai China: Education-based cutoff points for CMMSE scores

## Objectives: To evaluate cognitive impairment (ci) in rural china using the chinese version of the mini-mental status examination (cmmse) and compare the prevalence of ci using two different cutoff points. ## Materials & methods: A population-based survey was conducted of 2809 people aged 60 years and above in a community of two towns (huaxin and xujing) in the qingpu district, located in the western suburb of shanghai. face-to-face interviews were carried out to collect relevant information with questionnaires. the chinese version of the mini-mental state examination with either a 23/24 cutoff point or a cutoff point varying according to education level (ael) was used to screen subjects for ci. ## Results: Among these subjects, the mean age was 70.6 years (sd = 6.6) and ranged from 60 to 92 years and included 1010 (36.0%) men and 1799 (64.0%) women. the mean age was 70.7 years (sd = 6.4) for men and 70.5 years (sd = 6.7) for women. of the 2809 subjects, 2010 (71.5%) had no formal education, 607 (21.6%) completed 1-6 years of education, and 173 (6.2%) completed more than 6 years of school education. the prevalence of ci was 35.6% (95% ci: 33.8-37.4) for both genders when the cutoff point of 23/24 was used. however, when the cutoff point was altered with respect to different education levels, the prevalence of ci was 7.0%. for each item of the cmmse, increased years of education correlated with a higher item score, with the exception of the 'naming' item score. ## Conclusions: This study demonstrates that screening of ci using the ael cutoff scores is feasible in a low-education population. determining whether the 23/24 cutoff point is suitable for the chinese people requires future prospective studies in a large chinese population.