{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:40:02Z","timestamp":1785883202320,"version":"3.56.0"},"reference-count":71,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T00:00:00Z","timestamp":1681776000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2023,4,18]]},"abstract":"<jats:p>Background: Accurately identifying cognitive changes in Mexican American (MA) adults using the Mini-Mental State Examination (MMSE) requires knowledge of population-based norms for the MMSE, a scale which has widespread use in research settings. Objective: To describe the distribution of MMSE scores in a large cohort of MA adults, assess the impact of MMSE requirements on their clinical trial eligibility, and explore which factors are most strongly associated with their MMSE scores. Methods: Visits between 2004\u20132021 in the Cameron County Hispanic Cohort were analyzed. Eligible participants were \u226518 years old and of Mexican descent. MMSE distributions before and after stratification by age and years of education (YOE) were assessed, as was the proportion of trial-aged (50\u201385\u2013 year-old) participants with MMSE &lt;24, a minimum MMSE cutoff most frequently used in Alzheimer\u2019s disease (AD) clinical trials. As a secondary analysis, random forest models were constructed to estimate the relative association of the MMSE with potentially relevant variables. Results: The mean age of the sample set (n\u200a=\u200a3,404) was 44.4 (SD, 16.0) years old and 64.5% female. Median MMSE was 28 (IQR, 28-29). The percentage of trial-aged participants (n\u200a=\u200a1,267) with MMSE &lt;24 was 18.6% overall and 54.3% among the subset with 0\u20134 YOE (n\u200a=\u200a230). The five variables most associated with the MMSE in the study sample were education, age, exercise, C-reactive protein, and anxiety. Conclusion: The minimum MMSE cutoffs in most phase III prodromal-to-mild AD trials would exclude a significant proportion of trial-aged participants in this MA cohort, including over half of those with 0\u20134 YOE.<\/jats:p>","DOI":"10.3233\/jad-220934","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T10:49:58Z","timestamp":1677840598000},"page":"1323-1339","source":"Crossref","is-referenced-by-count":10,"title":["Population-Based Mini-Mental State Examination Norms in Adults of Mexican Heritage in the Cameron County Hispanic Cohort"],"prefix":"10.1177","volume":"92","author":[{"given":"Avram S.","family":"Bukhbinder","sequence":"first","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"},{"name":"Division of Pediatric Neurology, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Hinojosa","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristofer","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Farrell","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Shyer","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Goodwin","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Anjum","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern 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H.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guadalupe J.","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Licong","family":"Cui","sequence":"additional","affiliation":[{"name":"School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-Qiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA"},{"name":"School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan P.","family":"Fisher-Hoch","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Brownsville, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph B.","family":"McCormick","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Brownsville, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul 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