Exploring racial performance disparities with the Modified Mini-Mental State Exam (3MS) in an acute brain injury rehabilitation setting.
Kritzia Merced, Mickeal Pugh, Daniel W Klyce and 2 others
PMID 36095240WHAT IT FOUND
Black patients scored lower than White patients on specific 3MS items for repetition and comprehension, even after adjusting for age and injury type.
Total scores showed no racial difference. A low total score should not be read as impairment without considering the patient's history and race.
Key findings
01There were no significant racial differences in 3MS total scores.
02Black participants scored significantly lower on Abstract Reasoning, Repetition, Visuospatial Construction, and Comprehension items compared to White participants.
03Significant differences remained in Repetition and Comprehension scores when adjusting for age and type of diagnosis.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study could not examine the factor structure of the 3MS differentially by racial/ethnic group or injury type due to sample size limitations. The sample was limited to individuals with diffuse (e.g., TBI) or focal (e.g., stroke) brain injuries in acute rehabilitation settings, so findings may not generalize to other populations or community settings. The study design was not pre-registered. Factors at the patient level (e.g., access to healthcare, insurance status) and systemic level (e.g., proximity to emergency services) were not measured or controlled for, which could contribute to observed differences.
Declared interests
The paper does not report specific funding sources or author conflicts of interest in the provided text.
The easy way to misread this
Do not interpret lower scores on Repetition and Comprehension items in Black patients as definitive evidence of cognitive impairment. The study found no difference in total scores, and item-level differences persisted even after controlling for age and injury type, suggesting potential cultural bias in specific test items rather than a global cognitive deficit.