Detecting dementia with the mini-mental state examination in highly educated individuals.
Detecting dementia with the mini-mental state examination in highly educated individuals.
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DOI：
10.1001/archneur.65.7.963
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发表时间：
2008-07
影响因子：
--
通讯作者：
Lucas, John A.
中科院分区：
文献类型：
--
作者：
O'Bryant, Sid E.;Humphreys, Joy D.;Smith, Glenn E.;Ivnik, Robert J.;Graff-Radford, Neill R.;Petersen, Ronald C.;Lucas, John A.
评估简易精神状态检查表（MMSE）评分在检测高学历个体样本认知功能障碍中的效用。
对梅奥诊所阿尔茨海默病研究中心（ADRC）和阿尔茨海默病患者登记处（ADPR）的4248名参与者的存档数据进行了回顾。
确定了1141名主要为白人（93%）且自我报告受教育16年或以上的个体。其中包括307例（164名男性和143名女性）痴呆病例（任何类型）、176名轻度认知障碍患者（106名男性和70名女性）以及658名非痴呆对照者（242名男性和416名女性）。
梅奥诊所ADRC和ADPR队列。
MMSE分界值在检测认知功能障碍中的诊断准确性估计（敏感性、特异性、阳性和阴性预测能力）。
在这个高学历、以白人为主的老年样本中，检测痴呆时，MMSE的标准分界值24分（23分及以下）的敏感性为0.66，特异性为0.99，总体正确分类率为89%。分界值为27分（26分及以下）时，敏感性和特异性达到最佳平衡（分别为0.89和0.91），总体正确分类率为90%。在认知受损组（痴呆和轻度认知障碍）中，分界值为27分（敏感性 = 0.69，特异性 = 0.91）或28分（敏感性和特异性 = 0.78）可能更合适。
有大学学历且自述（或他人报告）有认知能力下降并在MMSE中得分低于27分的老年患者，被诊断为痴呆的风险更高，应转诊进行全面的痴呆评估，包括正式的神经心理学测试。
To evaluate the utility of Mini-Mental State Examination (MMSE) scores in detecting cognitive dysfunction in a sample of highly educated individuals. Archival data were reviewed on 4248 participants enrolled in the Mayo Clinic Alzheimer's Disease Research Center (ADRC) and Alzheimer's Disease Patient Registry (ADPR). 1141 primarily Caucasian (93%) individuals with 16 or more years of self-reported education were identified. These included 307 (164 males and 143 females) dementia cases (any type), 176 patients with Mild Cognitive Impairment (106 males and 70 females), and 658 nondemented controls (242 males and 416 females). Mayo Clinic ADRC and ADPR cohort. Diagnostic accuracy estimates (sensitivity, specificity, positive and negative predictive power) of MMSE cut-scores in detecting cognitive dysfunction. In this sample of highly educated, largely Caucasian older adults, the standard MMSE cut-score of 24 (23 or below) yielded a sensitivity of .66, specificity of .99 and an overall correct classification rate of 89% in detecting dementia. A cut score to 27 (26 or below) resulted in an optimal balance of sensitivity and specificity (.89 and .91, respectively) with an overall correct classification rate of 90%. In a cognitively impaired group (dementia and MCI), a cut-score of 27 (sensitivity = .69, specificity = .91) or 28 (sensitivity and specificity = .78) might be more appropriate. Elderly patients with college education who present with complaints of cognitive decline (self- or other-report) and score below 27 on the MMSE are at greater risk of being diagnosed with dementia and should be referred for a comprehensive dementia evaluation, including formal neuropsychological testing.
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影响因子：
3.9
作者：
Lucas, JA;Ivnik, RJ;Graff-Radford, NR
通讯作者：
Graff-Radford, NR
影响因子：
3.9
作者：
Steinberg, BA;Bieliauskas, LA;Malec, JF
通讯作者：
Malec, JF
影响因子：
9.9
作者：
Mungas, D;Marshall, SC;Reed, BR
通讯作者：
Reed, BR
影响因子：
2.6
作者：
BENEDICT, RHB;BRANDT, J
通讯作者：
BRANDT, J
影响因子：
2.6
作者：
Nys, GMS;van Zandvoort, MJE;de Haan, EHF
通讯作者：
de Haan, EHF