Exploring Literacy-Related Disparities in Cognitive Assessment: A Comparative Analysis of Modified MMSE (MACE) and (HMSE) Performance in Older Adults

Abstract

This study investigates cognitive assessment disparities between literate and illiterate individuals through a comprehensive analysis of the Modified MMSE (MACE) and the HMSE. Using a sample of older adults, the research examines correlations in scores across various cognitive domains, revealing significant associations among literate subjects but non-significant correlations among illiterate individuals. Item differences between MACE and HMSE introduce biases in illiterate subjects' scoring profiles, rendering them more vulnerable to higher positivity on MACE than HMSE. The ranking and weighted percentage data highlight variations in subtest difficulty. Despite the small sample size, qualitative comparisons underscore the need for culturally and linguistically sensitive cognitive assessments tailored to diverse educational backgrounds. The study's implications for clinical practice and recommendations for future research are discussed, emphasizing the importance of nuanced interpretations in cognitive assessment.