The Distribution of Thai Mental State Examination
Scores among Non-Demented Elderly in Suburban
Bangkok Metropolitan and Associated Factors
Weerasak Muangpaisan MD*,
Prasert Assantachai MD*, Kobkul Sitthichai BSc**,
Kathryn Richardson PhD***, Carol Brayne MD***
Affiliation :
* Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Primary Care Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
*** Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK
Objective : To obtain the distribution of Thai Mental State Examination (TMSE) scores in the Thai population across different
age groups and educational levels in men and women aged 50 years and older and its relationship with demographic factors.
The different cutpoints in literate and illiterate participants and item performance in both groups were also determined.
Material and Method: Community-dwelling participants aged 50 years and over were invited to join the study. Personal
information, general health history, and specific illness questionnaires including the activities of daily living, designed by
the Survey in Europe on Nutrition and the Elderly, a Concerted Action (SENECA), and the Thai Mental State Examination
(TMSE) were completed in the face-to-face interview.
Results : There were 4,459 participants with no specific reported conditions that could potentially influence cognitive
performance. The mean (SD) age was 64.2 (7.9) years and most participants were women (71.7%). The median (interquartile
range) of the TMSE was 27 (25-29) and 23 (19-26) in literate and illiterate participants, respectively. The distribution of
TMSE scores were reported here determined by age, gender, and educational level. Percentage of correct response in each
TMSE item was low in recall and calculation performance. TMSE score declined with age in both genders and had greater
variation with increasing age. TMSE score also increased with increasing levels of education and better financial status.
Gender was not associated with the TMSE score adjusting for age, educational level, and economic status.
Conclusion : Age, education, and economic status have an influence on the TMSE performance. Controlling for these three
factors, genders does not contribute to significant differences in TMSE performance. Norms adjusted for these factors should
be considered before employing single cutpoints to identify impairment.
Keywords : Mental status, Cognitive function, Community, Elderly, Norm
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