Relationship between alcohol consumption and Folstein Mini-Mental Status Examination scores among older cognitively impaired adults
The purpose of this study was to determine whether older cognitively impaired adults with significant current or past alcohol histories manifest distinctive cognitive profiles as determined by a widely used cognitive screen, the Folstein Mini-Mental Status Examination (MMSE) test, when compared with older persons without significant alcohol histories. Study participants included 801 consecutive patients, ages 65 years or above, who underwent comprehensive geriatric assessments. Proxy-reported current alcohol intake was classified as none, former, light (<1 drink/week), moderate (> or = 1 but < 14 drinks/week), and heavy (> or = 14 drinks/week), and the presence of an alcohol abuse/dependence disorder was determined by medical record review. Potential exposure-outcome associations were assessed for patients (n = 470) with established cognitive impairment, defined as an MMSE score < 24, and for individuals with MMSE scores > or = 24 (n = 331). Among participants with established cognitive impairment, mean (total) MMSE scores were not significantly different (17.2 vs 16.4 vs 18.5 vs 18.5 vs 17.4) across the categories of current alcohol exposure (none, former, light, moderate, and heavy). Mini-Mental State Examination subscores also did not vary as a function of current alcohol consumption, and a history of alcohol abuse/dependence was not associated with differences in total scores or individual MMSE subscores in this patient group. Among participants with MMSE scores > 24, increased current use of alcohol or a history of alcohol abuse/dependence was not associated with lower total MMSE scores or individual MMSE subscores. Despite these negative findings, prospective investigations of older populations that incorporate more comprehensive cognitive measures are warranted because (1) the Folstein is a brief cognitive screen that does not assess all cognitive domains, and (2) alcohol is a demonstrated risk factor for adverse cognitive outcomes in middle-aged adults and is potentially modifiable.