Page 7 - IJPS-8-1

International Journal of

Population Studies

RESEARCH ARTICLE
Validity and reliability of Mini-Mental State

Examination in Older Adults in China: Inline
Mini-Mental State Examination with cognitive

functions

Teck Kiang Tan *, and Qiushi Feng 2
1
1 Institute for Applied Learning Sciences and Educational Technology, National University of
Singapore, Singapore
2 Department of Sociology, Centre for Family and Population Research, National University of
Singapore, Singapore

Abstract
The main aim of the study is to validate the factor structure of the Mini-Mental State
Examination (MMSE) of China’s older population using the Chinese Longitudinal
Healthy Longevity Survey. The validation process used the exploratory factor analysis
(EFA) to determine the number of dimensions of MMSE, the confirmatory factor
analysis (CFA) to confirm the factorial structure of MMSE, and the factorial invariance
to conclude the factor structure does not differ between the young-old (aged 65 – 79)
and old-old (aged 80 or older). The results of the EFAs suggested two possible factor
structures: A six-factor and a seven-factor solution. The seven-factor confirmatory
factor model turned out as the best fit by comparison to the four competing
*Corresponding author:
Teck Kiang Tan confirmatory models. Strict factorial invariance was attained for the two age groups,
(Singapore.alsttk@nus.edu.sg) indicating a high level of measurement equality, a property of invariance was seldom
Citation: Tan TK, Feng Q. (2022). achieved in the literature of factorial invariance studies. In comparison to the MMSE
Validity and reliability of Mini- literature that focused solely on EFA that aims to establish a single summated score,
Mental State Examination in Older the present study suggests using EFA, CFA, and factorial invariance that takes into
Adults in China: Inline Mini-Mental
State Examination with cognitive consideration of measurement errors as the preferred procedure since it establishes
functions. International Journal of the appropriate MMSE dimensionality that is in line with their respective cognitive
Population Studies, 8(1):1-15. functions.
https://doi.org/10.36922/ijps.v8i1.1285
Received: February 23, 2022
Keywords: Mini-Mental State Examination; Validation; Exploratory factor analysis;
Accepted: May 17, 2022 Confirmatory factor analysis; Factorial invariance
Published Online: June 08, 2022
Copyright: © 2022 Author(s).
This is an Open-Access article
distributed under the terms of the 1. Introduction
Creative Commons Attribution
License, permitting distribution, The cognitive function represents an important health dimension of older adults, which
and reproduction in any medium, significantly affects their physical health, well-being, and mortality (Hsieh, Wu, Wang,
provided the original work is
properly cited. et al., 2021; Langa, Llewellyn, Lang, et al., 2009; Park, Kwon, Jung, et al., 2012; van der
Publisher’s Note: AccScience Meulen, Irven, Bakunina, et al., 2021). The Mini-Mental State Examination (MMSE)
Publishing remains neutral with was first introduced by Folstein et al. (1975) more than 40 years ago to measure cognitive
regard to jurisdictional claims in performance. Since then, MMSE was widely used and has been accepted as an overall
published maps and institutional
affiliations. measure of cognitive impairment in clinical, research, and community settings. The

Volume 8 Issue 1 (2022) 1 https://doi.org/10.36922/ijps.v8i1.1285