A five-point change in Modified Mini-Mental State Examination was clinically meaningful in community-dwelling elderly people
A five-point change in Modified Mini-Mental State Examination was clinically meaningful in community-dwelling elderly people
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DOI：
10.1016/j.jclinepi.2007.10.022
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发表时间：
2008-08-01
影响因子：
7.2
通讯作者：
Rockwood, Kenneth
中科院分区：
文献类型：
--
作者：
Andrew, Melissa K.;Rockwood, Kenneth
目的：为了确定修改后的简易智力状态检查(3MS)应该被认为是有意义的变化，该工具是一种经过验证和广泛使用的认知筛查工具，其有意义的变化分数尚未明确表征。研究设计和地点：作为基于人群的加拿大健康与老龄化研究的一部分，3MS在5年和10年后在基线水平上进行管理。在这个具有代表性的大型研究样本中，我们计算了Cohen的效应大小，以估计在5年和10年内3MS筛查分数的可检测变化。结果：在所有三个访谈中，共有3,255名居住在基线社区的老年人完成了3MS筛查面试。平均3MS评分t(1)为90.4(标准差[SD]6.9)，5年为89.1(SD 8.2)，10年为85.8(SD 13.0)。在5年和10年期间，变化1分多一点，代表了临床可检测到的中等效应大小的变化(Cohen‘s d=0.5)。结论：虽然>；=1分的变化在临床上是可检测到的，但考虑到临床意义的其他标准表明，>；=5分的变化很可能代表群体在临床上有意义的差异，在使用3MS定义个体认知变化的研究中，>；=5分的变化是合理的选择。(C)2008 Elsevier Inc.保留所有权利。
Objective: To determine what change in the Modified Mini-Mental State Examination (3MS), a validated and widely used cognitive screening tool for which meaningful change scores have not been clearly characterized, should be considered meaningful.Study Design and Setting: The 3MS was administered at baseline after 5 and 10 years, as part of the population-based Canadian Study of Health and Aging. We calculated Cohen's effect sizes to estimate detectable changes in 3MS screening scores over 5 and 10 years in this large and representative study sample.Results: A total of 3,255 older adults who were community dwelling at baseline completed the 3MS as part of a screening interview at all three interviews. Mean 3MS score was 90.4 (standard deviation [SD] 6.9) at t(1), 89.1 (SD 8.2) at 5 years, and 85.8 (SD 13.0) at 10 years. A change of just over one point, over 5 and 10 years, represented a clinically detectable change with a medium effect size (Cohen's d = 0.5).Conclusions: Although a change of >= 1 point was clinically detectable, consideration of additional criteria for clinical meaningfulness suggested that a change of >= 5 points likely represents a clinically meaningful difference for groups, and is a reasonable choice of cutoff in studies using the 3MS to define cognitive change in individuals. (c) 2008 Elsevier Inc. All rights reserved.