International Journal of Population Studies | 2022, Volume 8, Issue 1 1 RESEARCH ARTICLE Validity and reliability of Mini-Mental State Examinaton in Older Adults in China: Inline Mini-Mental State Examinaton with cognitve functons Teck Kiang Tan 1 *, Qiushi Feng 2 1 Institute for Applied Learning Sciences and Educational Technology, National University of Singapore, Singapore 2 Department of Sociology, Centre for Family and Population Research, National University of Singapore, Singapore Abstract: The main aim of the study is to validate the factor structure of the Mini-Mental State Examination (MMSE) of China’s older population using the Chinese Longitudinal Healthy Longevity Survey. The validation process used the exploratory factor analysis (EFA) to determine the number of dimensions of MMSE, the confrmatory factor analysis (CFA) to confrm the factorial structure of MMSE, and the factorial invariance to conclude the factor structure does not difer between the young-old (aged 65 – 79) and old-old (aged 80 or older). The results of the EFAs suggested two possible factor structures: A six-factor and a seven-factor solution. The seven-factor confrmatory factor model turned out as the best ft by comparison to the four competing confrmatory models. Strict factorial invariance was attained for the two age groups, indicating a high level of measurement equality, a property of invariance was seldom achieved in the literature of factorial invariance studies. In comparison to the MMSE literature that focused solely on EFA that aims to establish a single summated score, the present study suggests using EFA, CFA, and factorial invariance that takes into consideration of measurement errors as the preferred procedure since it establishes the appropriate MMSE dimensionality that is in line with their respective cognitive functions. Keywords: Mini-Mental State Examination; Validation; Exploratory factor analysis; Confrmatory factor analysis; Factorial invariance 1. Introduction The cognitive function represents an important health dimension of older adults, which signifcantly afects their physical health, well-being, and mortality (Hsieh, Wu, Wang, et al., 2021; Langa, Llewellyn, Lang, et al., 2009; Park, Kwon, Jung, et al., 2012; van der Meulen, Irven, Bakunina, et al., 2021). The Mini-Mental State Examination (MMSE) was frst introduced by Folstein et al. (1975) more than 40 years ago to measure cognitive performance. Since then, MMSE was widely used and has been accepted as an overall measure of cognitive impairment in clinical, research, and community settings. The MMSE is nowadays a widely used test of cognitive function among older adults. Its usability and applicability were well noted in social and medical research as a short screening tool, especially for older adults at risk of mild cognitive impairment (Folstein, Folstein, and McHugh, 1975; Lezak, Howieson, and Loring, 2004), screening the risk of dementia and Alzheimer’s disease (Burke, Grudzien, Burgess, et al., 2021; Mitchell, 2009; Arevalo- Rodriguez, Smailagic, Roqué-Figuls, et al., 2021; Shigemori, Ohgi, Okuyama, et al., 2010). International Journal of Population Studies ARTICLE INFO Received: February 23, 2022 Accepted: May 17, 2022 Published: June 8, 2022 *CORRESPONDING AUTHOR Teck Kiang Tan, Institute for Applied Learning Sciences and Educational Technology, National University of Singapore, Singapore. alsttk@nus.edu.sg CITATION Tan TK, Feng Q. (2022). Validity and reliability of Mini- Mental State Examination in Older Adults in China: Inline Mini-Mental State Examination with cognitive functions. International Journal of Population Studies, 8(1):1-16. doi: 10.18063/ijps.v8i1.1285 Copyright: ©2022 Tan and Feng. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (http://creativecommons.org/ licenses/by-nc/4.0/), permitting all noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.