Schultz-Larsen Kirsten, Lomholt Rikke Kirstine, Kreiner Svend
Center for Elder Research, Øster Søgade 18, 2, DK-1357 Copenhagen K, Denmark.
J Clin Epidemiol. 2007 Mar;60(3):260-7. doi: 10.1016/j.jclinepi.2006.06.008. Epub 2006 Aug 14.
This study assesses the properties of the Mini-Mental State Examination (MMSE) with the purpose of improving the efficiencies of the methods of screening for cognitive impairment and dementia. A specific purpose was to determine whether an abbreviated version would be as accurate as the original MMSE in predicting dementia.
A population-based post hoc examination of the performance characteristics of the MMSE for detecting dementia in an existing data set of 243 elderly persons.
Sensitivity, specificity, and predictive values were computed for the original MMSE as well as new MMSE scale models derived from a Rasch model item analysis. The optimal threshold for the original MMSE screen yielded sensitivity and specificity estimates of 72.5% and 91.3%, respectively. The use of a subscale resulted in a slightly lower sensitivity (71.0%), specificity (88.4%), and positive predictive value (71.0%) but equal area under the receiver operating characteristic curve. Cross-validation on follow-up data confirmed the results.
A short, valid MMSE, which is as sensitive and specific as the original MMSE for the screening of cognitive impairments and dementia is attractive for research and clinical practice, particularly if predictive power can be enhanced by combining the short MMSE with neuropsychological tests or informant reports.
本研究评估简易精神状态检查表（MMSE）的特性，以提高认知障碍和痴呆症筛查方法的效率。一个特定目的是确定一个简化版本在预测痴呆症方面是否与原始MMSE一样准确。
对一个包含243名老年人的现有数据集中MMSE检测痴呆症的性能特征进行基于人群的事后检验。
计算了原始MMSE以及通过拉施模型项目分析得出的新MMSE量表模型的敏感性、特异性和预测值。原始MMSE筛查的最佳阈值产生的敏感性和特异性估计值分别为72.5%和91.3%。使用一个子量表导致敏感性（71.0%）、特异性（88.4%）和阳性预测值（71.0%）略低，但受试者工作特征曲线下面积相等。对随访数据的交叉验证证实了结果。
一个简短、有效的MMSE，在筛查认知障碍和痴呆症方面与原始MMSE一样敏感和特异，对研究和临床实践具有吸引力，特别是如果通过将简短MMSE与神经心理学测试或知情人报告相结合可以提高预测能力的话。
