Education and sex differences in the mini-mental state examination: Effects of differential item functioning
Education and sex differences in the mini-mental state examination: Effects of differential item functioning
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DOI：
10.1093/geronb/57.6.p548
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发表时间：
2002-11-01
影响因子：
6.2
通讯作者：
Gallo, JJ
中科院分区：
文献类型：
--
作者：
Jones, RN;Gallo, JJ
完成教育的年数与心理状态评估的表现有很强的相关性。该分析评估了归因于教育水平和性别的认知表现差异。我们使用基于项目反应理论的结构方程分析框架，分析了来自大社区样本（流行病学集水区研究，N = 8，556）的简易精神状态检查反应。显著的性别和教育组差异项目功能（DIF）检测。受教育程度低的人更容易在第一个序列减法、倒拼世界、重复短语、书写、命名季节和复制设计任务中出错。女性在所有的连环画减法上更容易出错，男性在拼写和其他语言任务上更容易出错。检测到的DIF的幅度很小。我们的分析表明，未能解释DIF导致高教育和低教育群体之间评估认知差异的幅度高估约1.6%。相反，几乎所有（95%）明显的性别差异潜在的认知障碍是由于DIF。因此，项目偏见似乎不是一个主要的来源，观察到的差异认知状态的教育程度。这些结果不支持消除教育群体差异的总分调整。我们的研究结果对未来有关教育和痴呆症风险的研究具有启示意义。
Years of completed education is a powerful correlate of performance on mental status assessment. This analysis evaluates differences in cognitive performance attributable to level of education and sex. We analyzed Mini-Mental State Examination responses from a large community sample (Epidemiologic Catchment Area study, N = 8,556), using a structural equation analytic framework grounded in item response theory. Significant sex and education group differential item functioning (DIF) were detected. Those with low education were more likely to err on the first serial subtraction, spell world backwards, repeat phrase, write, name season, and copy design tasks. Women were more likely to err on all serial subtractions, men on spelling and other language tasks. The magnitude of detected DIF was small. Our analyses show that failing to account for DIF results in an approximately 1.6% overestimation of the magnitude of difference in assessed cognition between high- and low-education groups. In contrast, nearly all (95%) of apparent sex differences underlying cognitive impairment are due to DIF. Therefore, item bias does not appear to be a major source of observed differences in cognitive status by educational attainment. Adjustments of total scores that eliminate education group differences are not supported by these results. Our results have implications for future research concerning education and risk for dementia.