Distinct Patterns of Cognitive Aging Modified by Education Level and Gender among Adults with Limited or No Formal Education: A Normative Study of the Mini-Mental State Examination
Distinct Patterns of Cognitive Aging Modified by Education Level and Gender among Adults with Limited or No Formal Education: A Normative Study of the Mini-Mental State Examination
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DOI：
10.3233/jad-143066
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发表时间：
2016-01-01
影响因子：
4
通讯作者：
Huo, Yong
中科院分区：
文献类型：
--
作者：
Xie, Haiqun;Zhang, Chengguo;Huo, Yong
背景：由于人口迅速老龄化，痴呆症越来越普遍，但在教育水平低的人群中认识不足。这部分是由于缺乏适当的和精确的规范性数据，低估了认知老化的筛查工具的使用demential.Objective：我们的目的是提高筛查认知损害的精度，通过表征认知老化的模式和衍生的规范性数据的简易精神状态检查（MMSE）的文盲和低学历人群。这项以社区为基础的研究包括来自两个农村地区的2,280名40岁或以上的人的数据。多元线性模型研究了年龄对MMSE所反映的认知的影响，按教育水平和性别分层。年龄对认知的阈值效应进行了使用smoothingfunction.Results：大多数的参与者（60.4%）是文盲或只参加过小学（24.6%）。年龄对认知的影响因性别和教育程度而异。受过小学教育的女性和男性在62岁和71岁之前的认知能力保持稳定，此后女性和男性的MMSE评分分别下降0.4和0.8分/年。女性文盲的得分比男性文盲低2.3分，两者的得分每年都下降0.2分。根据这些结果，规范性数据分层的年龄，教育和gender generated.Conclusion：本研究表明，性别和教育差异存在于认知老化的成年人有限或没有正规教育。为提高MMSE在低文化程度人群中认知功能障碍筛查的准确性，应考虑年龄、性别、文化程度等因素。
Background: Dementia is increasingly prevalent due to rapid aging of the population, but under-recognized among people with low education levels. This is partly due to a lack of appropriate and precise normative data, which underestimates cognitive aging in the use of screening tools for dementia.Objective: We aimed to improve the precision of screening for cognitive impairment, by characterizing the patterns of cognitive aging and derived normative data of the Mini-Mental State Examination (MMSE) for illiterate and low-educated populations.Methods: This community-based study included data from 2,280 individuals aged 40 years or older from two rural areas. Multiple linear modeling examined the effect of aging on cognition reflected by the MMSE, stratified by education level and gender. Threshold effect of age on cognition was performed using a smoothing function.Results: The majority of participants (60.4%) were illiterate or had attended only primary school (24.6%). The effect of aging on cognition varied by gender and education. Primary-school educated females and males remained cognitively stable up to 62 and 71 years of age, respectively, with MMSE score declining 0.4 and 0.8 points/year in females and males thereafter. Illiterates females scored 2.3 points lower than illiterate males, and scores for both declined 0.2 points/year. According to these results, normative data stratified by age, education and gender was generated.Conclusion: This study suggests gender and educational differences exist in cognitive aging among adults with limited or no formal education. To improve screening precision for cognitive impairment with the use of MMSE in low-educated population, age, gender, and education level should be considered.