Predictors of performance on the MMSE and the DRS-2 among American Indian elders.
Predictors of performance on the MMSE and the DRS-2 among American Indian elders.
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美洲印第安人老年人 MMSE 和 DRS-2 表现的预测因素。
DOI：
10.1176/jnp.2010.22.4.417
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
Arciniegas,DavidB
中科院分区：
文献类型：
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作者：
Jervis,LoriL;Fickenscher,Alexandra;Beals,Janette;Cullum,CMunro;Novins,DouglasK;Manson,SperoM;Arciniegas,DavidB
一些小型的、非人口的实证研究调查了美洲印第安人和加拿大原住民中的痴呆症。 3-5, 18-24 总体而言，迄今为止，大多数关于认知测试表现的研究通常表明土著和非土著样本之间差异不大，尽管这些调查大多是针对相对文化化的部落进行的，3-5, 22, 25 其中一些部落的美洲印第安人遗传水平也相对较低。 21 这很重要，因为文化适应状态可能会影响老年人在认知测试中的表现。 26 该研究小组 27 早期的一项调查检查了美国老年印第安人在简易精神状态检查 (MMSE) 28 和马蒂斯痴呆评定量表第二版 (DRS-2) 29, 30 上的得分，与 NIMH 流行病学区域计划调查中 18,000 名社区居住参与者（年龄 18-85 岁）制定的年龄和教育调整标准进行了比较。 31 出于该调查的目的，可能的认知障碍被定义为表现比每个参与者相应年龄和教育匹配群体的平均值低 2 个标准差以上。根据这一标准，10.9% 的样本可能存在认知障碍。对于 DRS-2，没有大规模的、具有人口代表性的标准可用，因此采用了人口统计学上最具可比性的已发布标准。这些是年龄调整后的标准，源自 36 个欧洲裔美国人和 53 个非洲裔美国人的城市标准32，年龄和教育水平相当相似（平均年龄 74 岁 [SD5.9]，范围 62-95；平均教育年数 10. 5 年 [SD3.6]）。 32 再次采用比每个参与者的 DRS-2 评分平均值低两个标准差以上的表现标准来定义可能的损伤，27.4% 的老年人可能存在认知损伤。性别与 DRS-2 的测试和教育表现显着相关，后者的发现是由于 Vangel & Lichtenberg 1995 年标准中缺乏教育调整所致。该文章的结论是，检查种族、社会经济地位、教育类型/特征和语言对 MMSE 和 DRS-2 表现的可能影响对于理解认知测试表现和制定文化上适当的规范至关重要。 27
A handful of small, non-population-based, empirical studies have examined dementia among American Indian and Canadian First Nations people. 3–5, 18–24 Overall, most studies of cognitive test performance to date typically have shown little difference between Native and non-Native samples, although most of these investigations have been conducted with relatively acculturated tribes, 3–5, 22, 25 some of whom also have relatively low levels of genetic American Indian heritage. 21 This is important because acculturation status may affect elders’ performance on cognitive tests. 26 An earlier investigation by this research team27 examined older American Indians’ scores on the Mini-Mental State Examination (MMSE) 28 and the Mattis Dementia Rating Scale—Second Edition (DRS-2) 29, 30 compared with age-and education-adjusted norms developed with 18,000 community-dwelling participants (age 18–85 years) in the NIMH Epidemiological Catchment Area Program survey. 31 For the purpose of that investigation, possible cognitive impairment was defined as performance greater than 2 standard deviations below the mean of each participant’s corresponding age-and education-matched cohort. Utilizing this criterion, 10.9% of the sample had possible cognitive impairment. For the DRS-2, no large-scale, populationrepresentative norms were available, so the most demographically comparable published norms available were employed. These were age-adjusted norms derived from 36 European American and 53 African American urban norms32 with fairly similar age and education levels (mean age74 years [SD5. 9], range62–95; mean education10. 5 years [SD3. 6]). 32 Again employing the criterion of performance greater than two standard deviations below the mean of each participant’s DRS-2 score to an age-matched cohort to define possible impairment, 27.4% of elders had possible cognitive impairment. Gender was significantly associated with performance on both tests and education with the DRS-2, the latter finding accounted for by the lack of education adjustments in the Vangel & Lichtenberg 1995 norms. The article concluded that the examination of the possible effects of ethnicity, socioeconomic status, type/character of education, and language on MMSE and DRS-2 performance is essential in understanding cognitive test performance and developing culturally appropriate norms. 27