Aging Institute & Memory Clinic, Pontificia Universidad Javeriana Medical School, Bogotá, Colombia.
J Geriatr Psychiatry Neurol. 2011 Mar;24(1):9-18. doi: 10.1177/0891988710373597. Epub 2010 Jun 10.
To study the effect of education and language of response at the interview on performance in the Mini-Mental State Examination (MMSE) domains, we studied 2861 Mexican Americans aged 65 and older from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (EPESE) followed from 1993 to 1994 until 2004 to 2005. The MMSE was examined as total score (0-30) or divided into 2 global domains: (1) no-memory (score 0-24): Orientation, attention, and language; and (2) memory (score 0-6): working and delayed memory. Mean age and total MMSE were 72.7 years and 24.6 at baseline, and 81.7 years and 20.5 at 11 years of follow-up. Spanish-speaking participants had less education (4.1 vs 7.4 years, P < .0001), they had significantly higher adjusted mean scores for memory, no-memory, and total MMSE compared with English-speaking participants. In multivariate longitudinal analyses, participants with more years of education performed better than those with less education, especially in total MMSE and no-memory domain. Spanish-speaking participants with 4 to 6 years of education had higher memory scores than those speaking English (estimate 0.40, standard error [SE] = 0.14, P < .001), 7 to 11 (estimate 0.27, standard error = 0.13, P < .01) or 12+ (estimate 0.44, standard error = 0.13, P < .001). Results suggest that cultural factors and variables related to preferred language use determined variations in MMSE performance. Because the memory domain of the MMSE is less affected by education, it may be used along with other cognitive tests for early detection of cognitive decline in older populations with low education.
为了研究访谈中教育和回应语言对简易精神状态检查（MMSE）各领域表现的影响，我们对 1993 年至 1994 年至 2004 年至 2005 年期间随访的 2861 名年龄在 65 岁及以上的墨西哥裔美国人进行了研究。该研究将 MMSE 作为总分（0-30）或分为 2 个全球领域进行研究：（1）无记忆（0-24 分）：定向、注意力和语言；（2）记忆（0-6 分）：工作和延迟记忆。基线时的平均年龄和总 MMSE 分别为 72.7 岁和 24.6，11 年随访时分别为 81.7 岁和 20.5。说西班牙语的参与者受教育程度较低（4.1 年 vs. 7.4 年，P<.0001），与说英语的参与者相比，他们的记忆、无记忆和总 MMSE 的调整后平均得分明显更高。在多变量纵向分析中，受教育程度较高的参与者比受教育程度较低的参与者表现更好，尤其是在总 MMSE 和无记忆领域。受教育程度为 4 至 6 年的讲西班牙语的参与者的记忆得分高于讲英语的参与者（估计值 0.40，标准误差[SE] = 0.14，P<.001）、7 至 11 年（估计值 0.27，SE = 0.13，P<.01）或 12 年以上（估计值 0.44，SE = 0.13，P<.001）。结果表明，文化因素和与首选语言使用相关的变量决定了 MMSE 表现的差异。由于 MMSE 的记忆领域受教育程度的影响较小，因此它可以与其他认知测试一起用于检测受教育程度较低的老年人群认知能力下降。
