Assessment of Mild Cognitive Impairment with Mini Mental State Examination Among Adults in Southeast Nigeria

Author(s):

Onwuekwe IO

Background: Mild cognitive impairment is a recently described neuropsychiatric entity with the possibility of evolving into overt dementia. It has been found to respond to therapeutic intervention, thus halting or significantly retarding the progression to dementia. Resource‑poor countries like Nigeria can hardly afford to provide optimal care for dementia patients. Knowledge about mild cognitive impairment in Nigeria is limited. An appreciation of the probable burden may help stimulate and galvanize appropriate public health policies in response. Aim: This cross‑sectional, descriptive study sought to determine the frequency of subclinical mental state abnormalities in a cohort of apparently normal adult Nigerians. Subjects and Methods: One hundred and thirty‑five apparently normal adult Nigerians of both sexes seen at the University of Nigeria Teaching Hospital, Enugu, were interviewed. The Mini Mental State Examination (MMSE) of Folstein, Folstein, and McHugh was used to assess cognitive function in each subject at a single instance. The results obtained were analyzed using SPSS version 11.3 (Chicago, IL). Consent was obtained from each person and approval obtained from the hospital’s ethics review board. Results: A cut‑off score of ≥17 was obtained for normal cognitive function in this population using the MMSE. Minimum score obtained was 12, while the maximum score was 30. A mean (2SD) of 24.84 (7.94) was obtained on analysis of the overall MMSE scores of the 135 individuals. Cognitive impairment was identified in 5.93% (8/135) of the subjects examined. These persons thus represent otherwise normal functional individuals with unrecognized mild cognitive impairment who may be at risk of developing overt dementia in future. Conclusion: The concept of mild cognitive impairment needs further large‑scale studies in Nigerians with possible multi‑centre participation to fully elucidate the scope of the problem. Strategies for the appropriate management of dementia need to be strengthened.