Hohl U, Grundman M, Salmon D P, Thomas R G, Thal L J
Department of Neurosciences, University of California, San Diego, School of Medicine, USA.
J Int Neuropsychol Soc. 1999 May;5(4):301-7. doi: 10.1017/s1355617799544019.
Little information exists regarding the performance of Spanish-speaking versus English-speaking patients with Alzheimer's disease (AD) on the Mini-Mental State Examination and the Mattis Dementia Rating Scale. In an attempt to identify culturally biased MMSE items or DRS subscales, we matched Spanish-speaking Hispanic and English-speaking non-Hispanic White community-dwelling AD patients by their MMSE scores and examined specific items within each scale. Our findings indicate that Hispanic AD patients perform significantly worse than non-Hispanics in terms of total DRS score, scores on the DRS subscales for Conceptualization and Memory, and on serial subtraction (or backward spelling item) of the MMSE. While mildly to moderately demented Hispanic and non-Hispanic patients obtained comparable scores on the DRS, severely impaired Spanish-speaking participants obtained considerably lower DRS scores than their English-speaking counterparts. The discrepancy in the DRS scores of the severely impaired Hispanic and non-Hispanic examinees might reflect a cultural bias in the test or educational differences between the groups. Alternatively, the DRS may be more sensitive than the MMSE for detecting severe cognitive impairment in Hispanic patients.
关于讲西班牙语与讲英语的阿尔茨海默病（AD）患者在简易精神状态检查表（Mini-Mental State Examination）和马蒂斯痴呆评定量表（Mattis Dementia Rating Scale）上的表现，现有信息很少。为了识别存在文化偏见的简易精神状态检查表项目或痴呆评定量表分量表，我们根据简易精神状态检查表的分数，将讲西班牙语的西班牙裔和讲英语的非西班牙裔白人社区居住型AD患者进行匹配，并检查了每个量表中的特定项目。我们的研究结果表明，在痴呆评定量表总分、概念化和记忆分量表得分以及简易精神状态检查表的连续减法（或倒序拼写项目）方面，西班牙裔AD患者的表现明显比非西班牙裔患者差。虽然轻度至中度痴呆的西班牙裔和非西班牙裔患者在痴呆评定量表上获得了相当的分数，但严重受损的讲西班牙语参与者在痴呆评定量表上的得分明显低于讲英语的参与者。严重受损的西班牙裔和非西班牙裔受测者在痴呆评定量表得分上的差异可能反映了测试中的文化偏见或两组之间的教育差异。或者，痴呆评定量表在检测西班牙裔患者的严重认知障碍方面可能比简易精神状态检查表更敏感。
