Espino D V, Lichtenstein M J, Palmer R F, Hazuda H P
Division of Community Geriatrics, Department of Family Practice, the University of Texas Health Science Center at San Antonio, 78229, USA.
J Am Geriatr Soc. 2001 May;49(5):538-48. doi: 10.1046/j.1532-5415.2001.49111.x.
To examine differences in correlates of the Mini-Mental State Examination (MMSE) in a population-based sample of older Mexican Americans and European Americans and to provide empirical validation of the MMSE as an indicator of cognitive impairment in survey research in older Mexican Americans by comparing MMSE classification against performance on timed tasks with varying levels of cognitive demand.
A population-based cross-sectional study.
Trained bilingual staff administered the MMSE as part of the San Antonio Longitudinal Study of Aging (SALSA) home-based assessment battery.
827 community-dwelling Mexican Americans and European Americans, 65 and older, residing in three socioeconomically and culturally distinct neighborhoods (barrio, transitional, suburban).
The MMSE was compared against a variety of demographic, biomedical, and sociocultural variables ascertained by self-report and against performance-based measures of functional tasks representing varying levels of cognitive demand (Structured Assessment of Independent Living Skills (SAILS) subscales for food manipulation and money management).
Mexican Americans were 2.2 times more likely than European Americans to have MMSE scores <24. Multiple logistic regression analysis revealed that neighborhood was an independent predictor of low MMSE scores in Mexican Americans, with the relationship between ethnic group and MMSE explained by neighborhood. After adjusting for neighborhood type, no differences were noted between Mexican Americans and European Americans. Independent of other factors examined, low education was associated with low MMSE scores in both Mexican Americans and European Americans. Mexican Americans with MMSE scores <24 took significantly longer to complete four out of five performance-based food manipulation tasks and all three money management tasks.
Neighborhood type was a predictor of cognitive impairment. Education affected MMSE scores similarly in both ethnic groups. MMSE scores <24, indicative of cognitive impairment, were uniformly associated with functional impairment in both the Mexican Americans and European Americans. Among older Mexican Americans, MMSE-classified cognitive impairment was significantly associated with poorer performance on timed tasks with varying levels of cognitive demand independent of other correlates. A similar pattern of association was observed in European Americans. Thus, the MMSE appears to be a valid indicator of cognitive impairment in survey research in both older Mexican Americans and European Americans.
在以社区为基础的老年墨西哥裔美国人和欧裔美国人样本中，研究简易精神状态检查表（MMSE）相关因素的差异，并通过将MMSE分类与不同认知需求水平的定时任务表现进行比较，为MMSE作为老年墨西哥裔美国人调查研究中认知障碍指标提供实证验证。
一项基于社区的横断面研究。
训练有素的双语工作人员将MMSE作为圣安东尼奥衰老纵向研究（SALSA）家庭评估项目的一部分进行施测。
827名年龄在65岁及以上、居住在三个社会经济和文化特征各异社区（西班牙裔聚居区、过渡区、郊区）的社区居住墨西哥裔美国人和欧裔美国人。
将MMSE与通过自我报告确定的各种人口统计学、生物医学和社会文化变量进行比较，并与代表不同认知需求水平的功能性任务的基于表现的测量方法（用于食物处理和资金管理的独立生活技能结构化评估（SAILS）分量表）进行比较。
墨西哥裔美国人MMSE得分<24的可能性是欧裔美国人的2.2倍。多因素逻辑回归分析显示，社区是墨西哥裔美国人MMSE低分的独立预测因素，种族与MMSE之间的关系可由社区来解释。在调整社区类型后，墨西哥裔美国人和欧裔美国人之间未发现差异。在不考虑其他所研究因素的情况下，低教育水平与墨西哥裔美国人和欧裔美国人的低MMSE得分均相关。MMSE得分<24的墨西哥裔美国人在五项基于表现的食物处理任务中的四项以及所有三项资金管理任务上花费的时间明显更长。
社区类型是认知障碍的一个预测因素。教育对两个种族群体的MMSE得分影响相似。MMSE得分<24表明存在认知障碍，在墨西哥裔美国人和欧裔美国人中均与功能障碍一致相关。在老年墨西哥裔美国人中，MMSE分类的认知障碍与不同认知需求水平的定时任务表现较差显著相关，且独立于其他相关因素。在欧裔美国人中也观察到类似的关联模式。因此，在老年墨西哥裔美国人和欧裔美国人的调查研究中，MMSE似乎是认知障碍的一个有效指标。
