Variability in annual mini-mental state examination score in patients with probable Alzheimer disease -: A clinical perspective of data from the consortium to establish a registry for Alzheimer's disease
Variability in annual mini-mental state examination score in patients with probable Alzheimer disease -: A clinical perspective of data from the consortium to establish a registry for Alzheimer's disease
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DOI：
10.1001/archneur.56.7.857
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发表时间：
1999-07-01
影响因子：
--
通讯作者：
Heyman, A
中科院分区：
文献类型：
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作者：
Clark, CM;Sheppard, L;Heyman, A
目的：确定加入阿尔茨海默病登记联盟 (CERAD) 的阿尔茨海默病患者年度简易精神状态检查分数的变异性。患者：总共 372 名可能患有阿尔茨海默病的患者，经过 1 年或更长的随访。地点：美国各地 21 个 CERAD 临床中心。结果：返回进行纵向重新评估的 CERAD 患者平均每年下降 3.4 分接近简易精神状态检查的测量误差2.8分的SD。个体下降率存在很大差异。即使经过 4 年的随访，15.8% 的患者的简易精神状态检查评分（定义为初始评分变化 >3，即测量误差 1 个 SD）没有出现有临床意义的下降。简易精神状态检查分数变化率测量的有效性随着观察间隔的延长而提高，并且当观察间隔3年或更长时，对大多数患者来说是可靠的。结论：虽然简易精神状态检查是评估认知功能水平的有用筛查工具，但由于测量误差较大且年度分数变化很大，它在测量个体患者阿尔茨海默病进展情况方面的价值有限，时间少于3年。
Objective: To determine the variability in annual Mini-Mental State Examination scores of patients with Alzheimer disease enrolled in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD).Patients: A total of 372 patients with probable Alzheimer disease with 1 or more years of follow-up.Setting: Twenty-one CERAD clinical sites throughout the United States.Results: An average annual decline of 3.4 points in CERAD patients returning for longitudinal, reassessments was close to the SD of the measurement error of 2.8 points for the Mini-Mental State Examination. There was wide variability in individual rates of decline. Even with 4 years of follow-up, 15.8% of the patients had no clinically meaningful decline in Mini-Mental State Examination score (defined as a change in initial score >3, ie, 1 SD of measurement error). Validity of measurements of the rate of change in Mini-Mental State Examination scores improved with longer observation intervals and was reliable for most patients when observations were separated by 3 or more years.Conclusions: Although the Mini-Mental State Examination is a useful screening instrument to assess level of cognitive function, it has limited value in measuring the progression of Alzheimer disease in individual patients for periods less than 3 years because of a large measurement error and substantial variation in change in annual score.