Open Access Open Badges Research article

Examining the influence of gender, education, social class and birth cohort on MMSE tracking over time: a population-based prospective cohort study

Fiona Matthews1*, Riccardo Marioni2, Carol Brayne2 and Medical Research Council Cognitive Function and Ageing Study2

Author Affiliations

1 MRC Biostatistics Unit, Cambridge, UK

2 Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

For all author emails, please log on.

BMC Geriatrics 2012, 12:45  doi:10.1186/1471-2318-12-45

Published: 13 August 2012



Whilst many studies have analysed predictors of longitudinal cognitive decline, few have described their impact on population distributions of cognition by age cohort. The aim of this paper was to examine whether gender, education, social class and birth cohort affect how mean population cognition changes with age.


The Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) is a multi-centre population based longitudinal study of 13,004 individuals in England and Wales. Using ten years of follow-up data, mean Mini-mental State Examination (MMSE) scores were modelled by age and birth cohort adjusting for non-random drop-out. The model included terms to estimate cohort effects. Results are presented for five year age bands between 65–95 years.


At a population level, women show greater change in MMSE scores with age than men. Populations with lower education level and manual work also show similar effects. More recent birth cohorts have slightly higher scores.


Longitudinal data can allow examination of population patterns by gender, educational level, social class and cohort. Each of these major socio-demographic factors shows some effect on whole population change in MMSE with age.

MRC CFAS; Population norms; Cohort effects; MMSE; Longitudinal; Cognitive decline