中国临床心理学杂志

从55岁以上城乡居民MMSE得分特征上探讨其适用范围

关键词：认知老年人 MMSE

分类号：G449.1

出版年,卷(期):页码：2002,10(1):10-13

摘要：

目的:探讨MMSE的适用人群及影响因素。方法:通过随机整群分层抽样,对4921名55岁或以上的西安市城乡居民进行MMSE测查。分析MMSE在不同人群中的得分特征对痴呆的阳性预测值和分析影响MMSE得分的因素。结果:MMSE得分在不同年龄、不同文化程度、总体人群中都呈现负偏态,尖峭峰型分布。在年龄较轻(70岁以下)、文化程度偏高(初中或以上)的人群中偏态分布最明显,痴呆的检出率较低;而在年龄偏大(70岁以上),文化程度偏低(小学及以下)的人群中接近正态分布,痴呆的检出率较高。年龄、性别、受教育年限、听力下降、日常生活能力对MMSE得分有显著影响。结论:MMSE量表最适用于年龄偏大(70岁以上),文化程度偏低(小学或以下)的人群,对痴呆的筛选能力大;而对于年龄偏小,文化程度偏高的人群,MMSE的鉴别筛选力较低。

Objective:To analyze the optimal application groups and influent factors of MMSE were studied.Methods:A total of 4921 old people aged 55 years and over were selected by means of randomized stratification cluster sampling from the urban and rural areas in Xi'an.The MMSE scores distribution and positive predictive values were analyzed among subjects of different ages and educational levels.Multiple stepwise regression method was used to evaluate significant variables.Results:MMSE scores showed a negative and cliff distributions for different ages,education levels,as well as for the whole sample.Moreover,these features were found to be most pronounced in relatively younger old subjects (less 70 years) with comparably higher educational levels (upper high school).Accordingly,the screening-out rates for dementia were higher among relatively older subjects with poor educational levels,when compared to younger and fairly well-educated subjects.Variables such as education,age,sex,hearing loss and daily functional abilities could significantly affect the MMSE score (P＜0.001).Conclusion:The MMSE scale can be best applied to older people (upper 70 years) with lower educational background (illiterate,elementary and below).Its performance as a screening instrument for dementia deteriorates significantly for younger subjects with higher educational levels.

基金项目：

国家九五攻关资助

作者简介：

参考文献：

[1] 彭海瑛、郑志学、朱汉民等,4510名老年人认知功能调查结果的分析中国老年学杂志,1999,19:65-67
[2] 吴文源、李玉珊、陆峥等综合性医院住院老年人认知功能的调查研究,中国心理卫生杂志,2000,14:206-08
[3] Hill RD,Backman L.The relationship between the mini-mental state examination and cognitive functioning in normal elderly adults;a componential analysis.Age Ageing 1995,24;440-446
[4] 孟琛、孟家眉,老年认知功能量表在正常人群的应用研究老年学杂志,1991,11:203-075
[5] Clarke M,Jagger C,Anderson J,et al.The prevalence of dementia in a total population;a comparison of two screening instruments.Age Ageing 1991,20;396-403
[6] 张明园、瞿光亚、金华等,几种痴呆测试工具的比较,中华神经精神科杂志,1991,24:194-196
[7] 张振馨、洪霞、李辉等,北京城乡55岁或以上居民简易智能状态检查测试结果的分布特征,中华神经科杂志,1999,32:149-53
[8] Jagger C,Clarke M,Anderson J,et al.Misclassification of dementia by the mini-mental state examination--are education and social class the only factors? Age Ageing 1992.21;404-411
[9] 李格、沈渔屯阝、陈昌惠等,老年痴呆简易测试方法研究,中国心理卫生杂志,1988,2:13-16
[10] Brayne C,Calloway P.The association of education and socioeconomicstatus with the Mini Mental State Examination and the clinical diagnosis of dementia in elderly people.Age Ageing 1990,19;91-96
[11] Cram RM,Anthony JC,Bassett SS,et al.Population-based norms for the Mini-Mental State Examination by age and educational level.JAMA,1993,269:2386-91
[12] Cummings JL.Mini-Mental State Examination-norms,normals,and numbers.JAMA,1993,269:2420-21

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