State University of Campinas, Campinas - SP - Brazil.
Int Psychogeriatr. 2012 Nov;24(11):1732-7. doi: 10.1017/S104161021200097X. Epub 2012 Jul 5.
In normal aging, the decrease in the syntactic complexity of written production is usually associated with cognitive deficits. This study was aimed to analyze the quality of older adults' textual production indicated by verbal fluency (number of words) and grammatical complexity (number of ideas) in relation to gender, age, schooling, and cognitive status.
From a probabilistic sample of community-dwelling people aged 65 years and above (n = 900), 577 were selected on basis of their responses to the Mini-Mental State Examination (MMSE) sentence writing, which were submitted to content analysis; 323 were excluded as they left the item blank or performed illegible or not meaningful responses. Education adjusted cut-off scores for the MMSE were used to classify the participants as cognitively impaired or unimpaired. Total and subdomain MMSE scores were computed.
40.56% of participants whose answers to the MMSE sentence were excluded from the analyses had cognitive impairment compared to 13.86% among those whose answers were included. The excluded participants were older and less educated. Women and those older than 80 years had the lowest scores in the MMSE. There was no statistically significant relationship between gender, age, schooling, and textual performance. There was a modest but significant correlation between number of words written and the scores in the Language subdomain.
Results suggest the strong influence of schooling and age over MMSE sentence performance. Failing to write a sentence may suggest cognitive impairment, yet, instructions for the MMSE sentence, i.e. to produce a simple sentence, may limit its clinical interpretation.
在正常衰老过程中，书面产出的句法复杂度下降通常与认知缺陷有关。本研究旨在分析语言流畅性（单词数）和语法复杂性（想法数）所反映的老年人大脑文本产出质量与性别、年龄、受教育程度和认知状态之间的关系。
从参加者人数为 900 人的社区居住的 65 岁及以上的概率样本中，根据他们在简易精神状态检查（MMSE）句子写作中的反应选择了 577 人进行内容分析；323 人因留空、书写不清或无意义而被排除在外。对 MMSE 进行教育调整截断分数，以将参与者分为认知受损或未受损。计算总 MMSE 和子域 MMSE 分数。
与被纳入分析的参与者相比，323 名被排除在外的参与者对 MMSE 句子的回答中有 40.56%的人认知受损，而被排除在外的参与者年龄较大且受教育程度较低。女性和 80 岁以上的人在 MMSE 中的得分最低。性别、年龄、受教育程度与文本表现之间没有统计学上的显著关系。书面单词数与语言子域得分之间存在适度但显著的相关性。
结果表明受教育程度和年龄对 MMSE 句子表现有强烈影响。无法写出一个句子可能表明认知受损，但 MMSE 句子的指令，即写出一个简单的句子，可能限制了其临床解释。
