Community screening for dementia: The mini mental state exam (MMSE) and modified mini-mental state exam (3MS) compared
Community screening for dementia: The mini mental state exam (MMSE) and modified mini-mental state exam (3MS) compared
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DOI：
10.1016/s0895-4356(97)00060-7
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发表时间：
1997-04-01
影响因子：
7.2
通讯作者：
Hebert, R
中科院分区：
文献类型：
--
作者：
McDowell, I;Kristjansson, B;Hebert, R
本研究的目的是评估Teng对简易精神状态检查（MMSE）的修改是否提高了其作为认知障碍和痴呆症筛查测试的性能，并在法语和英语语言组中重新复制这种比较，以及关于假阴性和假阳性错误的相对重要性的不同假设。筛选访谈进行了65岁或以上的人，在加拿大10个省的36个社区设置的代表性样本。有8900名社区参与者在加拿大的健康和老龄化研究，其中1600人也进行了广泛的临床和神经心理学检查。原始MMSE和改良版（3 MS）的敏感性、特异性和受试者工作特征（ROC）曲线下面积是主要的结局指标。报告了法文和英文版测试的结果。结果表明，3 MS的α内部一致性为0.87，而MMSE为0.78。在识别痴呆方面，3 MS和MMSE的ROC曲线下面积分别为0.93和0.89（p < 0.001）。在识别所有水平的认知障碍方面，两种测试之间的差异较小（AUC 0.80 vs 0.77，p < 0.01）。3 MS的优越性似乎更多地是由于其扩展的评分系统，而不是其额外的问题。MMSE的有效性在英语和法语样本中具有可比性;两个样本之间的3 MS结果不一致，表明可能存在翻译问题。总之，3 MS上级于MMSE，证明其管理和评分的负担略大。这两种测试都不能很好地识别较低水平的认知障碍。(C)1997年爱思唯尔科学公司
The objectives of this study were to assess whether Teng's modification of the Mini-Mental State Examination (MMSE) improves its performance as a screening test for cognitive impairment and dementia, and re, replicate this comparison in French and English language groups, and for differing assumptions concerning the relative importance of false negative and false positive errors. Screening interviews were conducted with representative samples of people aged 65 or over, set in 36 communities in 10 Canadian provinces. There were 8900 community participants in the Canadian Study of Health and Aging, of whom 1600 also underwent an extensive clinical and neuropsychological examination. Sensitivity, specificity and areas under the receiver operating characteristic (ROC) curve for the original MMSE and modified version (the 3MS) were the main outcome measures. Results are reported for French and English versions of the tests. The results indicate the alpha internal consistency for the 3MS was 0.87, compared to 0.78 for the MMSE. The area under the ROC curve in identifying dementia was 0.93 for the 3MS and 0.89 for the MMSE (p < 0.001). There was less difference between the two tests in identifying all levels of cognitive impairment (AUC 0.80 versus 0.77, p < 0.01). The superiority of the 3MS appears more due to its extended scoring system than to its additional questions. The validity of the MMSE was comparable in English and French samples; results for the 3MS were inconsistent between the two samples, suggesting possible translation problems. In conclusion, the 3MS was superior to the MMSE, justifying the slightly greater burden for its administration and scoring. Neither test worked well in identifying lower levels of cognitive impairment. (C) 1997 Elsevier Science Inc.