Meyer J S, Li Y S, Thornby J
Cerebrovascular Research Laboratories, Bldg. 110, Room 225, Holcombe Boulevard 151A, Houston, TX 77030, USA.
Int J Geriatr Psychiatry. 2001 Apr;16(4):430-5. doi: 10.1002/gps.359.
The Mini-Mental State Examination (MMSE) and Cognitive Capacity Screening Examination (CCSE) are easily and rapidly administered tests for quantifying the general cognitive status of young as well as geriatric subjects. Likewise, the Hamilton Depression Rating Scale (HDRS) is a brief instrument for quantifying depression that may confound cognitive test performances. Testing by means of all three scales concurrently provides useful information for longitudinal research among the elderly.
To validate the combined longitudinal use of MMSE, CCSE and HDRS among a specific cohort of normal subjects with vascular headaches characterized by known well-established temporary cognitive decline occurring only during temporary intervals with headache.
The MMSE, CCSE and HDRS were serially tested at 3-12 monthly intervals among 196 healthy subjects attending our out-patient headache clinic who suffered from migraine or cluster headaches. Stability and specificity of MMSE, CCSE and HDRS were evaluated by comparing consecutive normative scores during headache-free intervals. Sensitivity of MMSE and CCSE for detecting temporary cognitive decline were evaluated by comparing scores during headache and headache-free intervals.
CCSE, MMSE and HDRS gave stable headache-free normative values over intervals of 3-10 years among 182 subjects. Among 77 subjects during headache intervals, temporary cognitive decline were confirmed by both CCSE and MMSE (p < 0.0001). When cutoff points for both CCSE and MMSE normal scores were placed at >/= 27, specificity for detecting cognitively normal values for CCSE and MMSE when headache-free were 92.2 and 89.6%, respectively (p > 0.05), while sensitivity for detecting cognitively decline during headache intervals were 83.7 and 49%, respectively (p < 0.001). Compared with scoring by a single rater, reliability estimates for all three rating scales were slightly lower when tested by different raters, but these differences were not significant.
CCSE is reliable and more sensitive than MMSE for detecting cognitive decline.
简易精神状态检查表（MMSE）和认知能力筛查检查表（CCSE）是用于量化年轻人和老年人总体认知状态的简单快速的测试。同样，汉密尔顿抑郁评定量表（HDRS）是一种用于量化可能混淆认知测试表现的抑郁程度的简短工具。同时使用这三种量表进行测试可为老年人的纵向研究提供有用信息。
在一组特定的患有血管性头痛的正常受试者中验证MMSE、CCSE和HDRS的联合纵向使用情况，这些受试者具有已知的、仅在头痛发作的短暂间隔期间出现的、已确定的短暂认知能力下降。
对在我们门诊头痛诊所就诊的196名患有偏头痛或丛集性头痛的健康受试者，每隔3 - 12个月对MMSE、CCSE和HDRS进行系列测试。通过比较无头痛间隔期间连续的标准分数来评估MMSE、CCSE和HDRS的稳定性和特异性。通过比较头痛期间和无头痛期间的分数来评估MMSE和CCSE检测短暂认知能力下降的敏感性。
在182名受试者中，CCSE、MMSE和HDRS在3至10年的时间间隔内给出了稳定的无头痛标准值。在77名头痛发作期间的受试者中，CCSE和MMSE均证实了短暂认知能力下降（p < 0.0001）。当CCSE和MMSE正常分数的截断点设定为≥27时，无头痛时CCSE和MMSE检测认知正常值的特异性分别为92.2%和89.6%（p > 0.05），而头痛发作期间检测认知能力下降的敏感性分别为83.7%和49%（p < 0.001）。与单一评分者评分相比，当由不同评分者进行测试时，所有三种评定量表的可靠性估计值略低，但这些差异不显著。
CCSE在检测认知能力下降方面比MMSE更可靠、更敏感。
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