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

Published online by Cambridge University Press:  24 January 2024

Astrid M. Suchy-Dicey Open the ORCID record for Astrid M. Suchy-Dicey [Opens in a new window] ,
Thao T. Vo ,
Kyra Oziel ,
Dedra S. Buchwald ,
Lonnie A. Nelson ,
Steven P. Verney Open the ORCID record for Steven P. Verney [Opens in a new window]  and
Brian F. French
Astrid M. Suchy-Dicey*
Affiliation:
Huntington Medical Research Institutes, Pasadena, CA, USA Washington State University, Elson S Floyd College of Medicine, Seattle, WA, USA
Thao T. Vo
Affiliation:
Washington State University, College of Education, Pullman, WA, USA
Kyra Oziel
Affiliation:
Washington State University, Elson S Floyd College of Medicine, Seattle, WA, USA
Dedra S. Buchwald
Affiliation:
Washington State University, Elson S Floyd College of Medicine, Seattle, WA, USA
Lonnie A. Nelson
Affiliation:
Washington State University, College of Nursing, Spokane, WA, USA
Steven P. Verney
Affiliation:
University of New Mexico, Albuquerque, NM, USA
Brian F. French
Affiliation:
Washington State University, College of Education, Pullman, WA, USA
*
Corresponding author: Astrid M. Suchy-Dicey; Email: astrid.suchy-dicey@hmri.org
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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

American Indianhealth disparitiesneuropsychologycognitionpsychometrics3MSE
Type
Research Article
Information
Journal of the International Neuropsychological Society , First View , pp. 1 - 10
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of International Neuropsychological Society

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