Appelros P
Department of Neurology, Orebro University Hospital, Orebro, Sweden.
Acta Neurol Scand. 2005 Aug;112(2):88-92. doi: 10.1111/j.1600-0404.2005.00441.x.
The Mini-Mental State Examination (MMSE) is commonly used to evaluate cognition after stroke. The purpose of this study was to describe the properties of MMSE in relation to different stroke characteristics.
Subjects were survivors (n = 253) of a population-based cohort who had had a first-ever stroke 1 year earlier. At baseline, patients were evaluated with regard to stroke type, stroke severity, unilateral neglect, and prestroke dementia. The 1-year follow-up included an MMSE, a functional evaluation according to the modified Rankin Scale (MRS) and a question regarding subjective memory problems.
The mean MMSE was 24.9. Patients with lacunar infarction scored 26.6. Impact of hemisphere localization was insignificant. Twenty-nine percent of the patients had cognitive impairment (cut-off <24). After adjustment for age and education, 16% had cognitive impairment; 41% of the patients had subjective memory problems. The kappa-value between subjective memory problems and dichotomized MMSE was 0.21. Patients with cognitive impairment scored at average 1.8 higher on the MRS.
If cut-off is used, the MMSE should be adjusted for age and education; otherwise the prevalence of cognitive impairment may be overestimated. Cognitive impairment heavily influences functional outcome. Subjective memory problems correlate poorly with MMSE. The impact of hemisphere location may previously have been overestimated.
简易精神状态检查表（MMSE）常用于评估中风后的认知情况。本研究旨在描述MMSE与不同中风特征相关的特性。
研究对象为基于人群队列的幸存者（n = 253），他们在1年前首次发生中风。在基线时，对患者进行中风类型、中风严重程度、单侧忽视和中风前痴呆的评估。1年随访包括MMSE、根据改良Rankin量表（MRS）进行的功能评估以及关于主观记忆问题的询问。
MMSE的平均分为24.9。腔隙性梗死患者的得分为26.6。半球定位的影响不显著。29%的患者存在认知障碍（临界值<24）。在对年龄和教育程度进行调整后，16%的患者存在认知障碍；41%的患者有主观记忆问题。主观记忆问题与二分法MMSE之间的kappa值为0.21。认知障碍患者的MRS平均得分高1.8分。
如果使用临界值，MMSE应根据年龄和教育程度进行调整；否则认知障碍的患病率可能被高估。认知障碍严重影响功能结局。主观记忆问题与MMSE的相关性较差。半球位置的影响可能此前被高估了。
