Little information exists regarding the performance
of Spanish-speaking versus English-speaking patients
with Alzheimer's disease (AD) on the Mini-Mental State
Examination and the Mattis Dementia Rating Scale. In an
attempt to identify culturally biased MMSE items or DRS
subscales, we matched Spanish-speaking Hispanic and English-speaking
non-Hispanic White community-dwelling AD patients by their
MMSE scores and examined specific items within each scale.
Our findings indicate that Hispanic AD patients perform
significantly worse than non-Hispanics in terms of total
DRS score, scores on the DRS subscales for Conceptualization
and Memory, and on serial subtraction (or backward spelling
item) of the MMSE. While mildly to moderately demented
Hispanic and non-Hispanic patients obtained comparable
scores on the DRS, severely impaired Spanish-speaking participants
obtained considerably lower DRS scores than their English-speaking
counterparts. The discrepancy in the DRS scores of the
severely impaired Hispanic and non-Hispanic examinees might
reflect a cultural bias in the test or educational differences
between the groups. Alternatively, the DRS may be more
sensitive than the MMSE for detecting severe cognitive
impairment in Hispanic patients. (JINS, 1999,
5, 301–307.)