{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T12:38:16Z","timestamp":1776343096266,"version":"3.51.2"},"reference-count":26,"publisher":"FapUNIFESP (SciELO)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dement. neuropsychol."],"published-print":{"date-parts":[[2011,3]]},"abstract":"<jats:p>Abstract The Mini-Mental State Examination (MMSE) is a widely used screening test for cognitive impairment, but is heavily biased by education. Educational level has frequently been ranked using years of schooling, which may not be a good indirect measure of educational level because there is great heterogeneity in standards of schooling among populations and across regions of the same country. S-TOFHLA is a measure of health literacy with some results indicating that it is a good measure for literacy level.  Objective: To evaluate the correlations between years of schooling and scores on the S-TOFHLA and the MMSE.  Methods: Healthy subjects without cognitive impairment were submitted to the S-TOFHLA and the MMSE. Correlations and regression analysis were performed to determine possible associations among variables.  Results: Both years of schooling and S-TOFHLA scores were strongly correlated with MMSE scores, but the strongest association was reached by the S-TOFHLA (r=0.702, p&lt;0.01), where the S-TOFHLA was the best predictor of MMSE scores (R2=0.494, p&lt;0.001).  Conclusions: A stronger association between S-TOFHLA scores and MMSE performance was found than between years of education and MMSE scores. This finding justifies further studies incorporating years of schooling together with S-TOFHLA score, to evaluate cognitive performance.<\/jats:p>","DOI":"10.1590\/s1980-57642011dn05010005","type":"journal-article","created":{"date-parts":[[2016,7,27]],"date-time":"2016-07-27T12:35:43Z","timestamp":1469622943000},"page":"26-30","source":"Crossref","is-referenced-by-count":31,"title":["Formal education, health literacy and Mini-Mental State Examination"],"prefix":"10.1590","volume":"5","author":[{"given":"Sonia Maria Dozzi","family":"Brucki","sequence":"first","affiliation":[{"name":"University of S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Let\u00edcia Lessa","family":"Mansur","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Carthery-Goulart","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Nitrini","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","series-title":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE)"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1017\/S1041610208008065","article-title":"Subjective memory impairment in a rural population with low education in the Amazon rainforest: an exploratory study","volume":"21","author":"Brucki SMD","year":"2009","journal-title":"Int Psychogeriatr"},{"key":"ref3","series-title":"Analfabetismo funcional: o mal nosso de cada dia","author":"Moreira DA","year":"2003"},{"key":"ref4","series-title":"Idosos no Brasil: viv\u00eancias, desafios e expectativas na terceira idade","author":"Neri AL","year":"2007"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1017\/S1041610209009430","article-title":"Prevalence of dementia in Latin America: a collaborative study of population-based cohorts","volume":"21","author":"Nitrini R","year":"2009","journal-title":"Int Psychogeriatr"},{"key":"ref6","first-page":"189","article-title":"Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician","volume":"13","author":"Folstein MF","year":"1975","journal-title":"J Psych Res"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1111\/j.1532-5415.1987.tb04002.x","article-title":"Predicting performance on the Mini-Mental State Examination: use of age- and education-specific equations","volume":"35","author":"Magaziner J","year":"1987","journal-title":"J Am Geriatr Soc"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1097\/00005053-198712000-00005","article-title":"Use of Mini-Mental State Examination in a probability sample of Hispanic population","volume":"175","author":"Bird HR","year":"1989","journal-title":"J Nerv Ment Dis"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1001\/jama.1993.03500180078038","article-title":"Population-based norms for the Mini-Mental State Examination by age and educational level.","volume":"369","author":"Crum RM","year":"1993","journal-title":"JAMA"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S0004-282X1994000100001","article-title":"O Mini-Exame do Estado Mental em uma popula\u00e7\u00e3o geral: impacto da escolaridade","volume":"52","author":"Bertolucci PHF","year":"1994","journal-title":"Arq Neuropsiquiatr"},{"key":"ref11","first-page":"777","article-title":"Suggestions for utilization of Mini-Mental State Examination in Brazil","volume":"61","author":"Brucki SMD","year":"2003","journal-title":"Arq Neuropsiquiatr"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1590\/S0102-311X2007000200007","article-title":"Mini-Mental State Examination norms in a community dwelling sample of elderly with low schooling in Brazil","volume":"23","author":"Laks J","year":"2007","journal-title":"Cad Saude Publica"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1590\/S1980-57642009DN30200004","article-title":"Evaluation of Mini-Mental State Examination scores according to different age and education strata, and sex, in a large Brazilian healthy sample","volume":"3","author":"Kochhann R","year":"2009","journal-title":"Dement Neuropsychol"},{"key":"ref14","first-page":"720","article-title":"Diagnosis of Alzheimer's disease in Brazil: cognitive and functional evaluation. 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