Adapting Mini-Mental State Examination for dementia screening among illiterate or minimally educated elderly Chinese
Adapting Mini-Mental State Examination for dementia screening among illiterate or minimally educated elderly Chinese
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DOI：
10.1002/gps.890
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发表时间：
2003-07-01
影响因子：
4
通讯作者：
Quach, M
中科院分区：
文献类型：
--
作者：
Xu, GL;Meyer, JS;Quach, M
文盲在当前的中国老年人中很普遍。很少有简短的中文认知测试，用于筛选那些可能患有痴呆症的人，以便在临床环境中进行更详细的评估。目的：本研究采用简易精神状态检查（MMSE）筛查中国文盲或受教育程度较低的老年人痴呆。方法将MMSE中与读写能力相关的项目修改或替换为与读写能力无关的同等项目。一些项目进行了修改，以提供社会文化兼容性。开发完成后，对中国西安西京医院的370例老年门诊患者进行了中国适应性MMSE (CAMSE)，其中93例为痴呆，277例为非痴呆。通过调整不同的CAMSE截止点来评估检测痴呆的敏感性和特异性。最佳分界点为文盲22点和文盲20点，灵敏度为83.87%，特异性为84.48%。阳性预测值（PPV）为0.65，阴性预测值（NPV）为0.94。识字对CAMSE和个别测试项目的影响也进行了评估。文盲组CAMSE总分高于识字组（p < 0.05）。在12个测试项目中，只有一个项目（序列7）受到文盲的负面影响（p < 0.01）。间隔4-6周后，随机选择32名受试者进行CAMSE重测。总分重测信度为0.75 （p < 0.01）。结果表明，在中国人的社会文化背景下，无论他们的读写能力如何，CAMSE被证明是可行的，可用于临床痴呆症筛查。版权所有：John Wiley Sons， Ltd。
Background Illiteracy is prevalent among current elderly Chinese. There are few brief cognitive tests in Chinese designed to screen those possibly demented for more detailed evaluation in a clinical setting.Objectives The present study adapted the Mini-Mental State Examination (MMSE) for screening dementia among illiterate or less educated elderly Chinese.Methods Literacy-dependent items of the MMSE were modified or substituted by equivalent items that are not literacy-dependment. Some items were modified to provide socio-cultural compatibility. After developing it, the Chinese adapted MMSE (CAMSE) was administered to 370 elderly outpatients from Xijing hospitals located in Xi'an, China, 93 of whom were found to be demented and 277 non-demented. Sensitivities and specificities for detecting dementia were evaluated by adjusting for different CAMSE cut-off points. The optimal cut-off points of 22 for literates and 20 for illiterates yielded a sensitivity of 83.87% and a specificity of 84.48%. Corresponding positive predictive value (PPV) was 0.65, and negative predictive value (NPV) was 0.94. The impact of literacy on CAMSE and individual test items was also evaluated. Illiterate subjects got a higher CAMSE total score than literate subjects (p < 0.05). Only one out of 12 test items, serial sevens, was negatively influenced by illiteracy (p < 0.01). After an interval of 4-6 weeks, 32 randomly selected subjects were retested with CAMSE. The test-retest reliability for total scores was 0.75 (p 0.01).Conclusions Results suggest that in the socio-cultural context for Chinese, irrespective of their literacy skills, CAMSE proved feasible for use in clinical settings for dementia screening. Copyright (C) 2003 John Wiley Sons, Ltd.