Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France.
Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Geneva University, Geneva.
Eur J Neurol. 2013 Mar;20(3):588-590. doi: 10.1111/j.1468-1331.2012.03830.x. Epub 2012 Aug 23.
To validate a Short Form of the Mini-Mental State Examination (SMMSE) as a screening test for dementia in older ambulatory individuals followed in a memory clinic for a memory complaint.
A total of 202 cognitively healthy individuals, 100 individuals with a mild cognitive impairment and 304 demented individuals sent for a memory complaint by their primary care physician to a memory clinic were prospectively included in this cross-sectional study. They were randomized into derivation (n = 303) and validation (n = 303) groups. The SMMSE score was built from six memory items of MMSE, with a score ranging from 0 to 6 (i.e. best performance).
The receiver operating characteristic curve showed an area under the curve of 0.98 for the derivation group and 0.97 for the validation group without differences between curves (P = 0.254). The cut-off between the sensitivity and the specificity of the SMMSE score for clinically diagnosed dementia was ≤4. The performance of the SMMSE for the diagnosis of dementia was high in the derivation and validation groups: sensitivity at 93.1% and 93.8%, specificity at 93.8% and 90.5%, positive predictive value at 94.3% and 90.1%, negative predictive value at 92.5% and 94.0%, likelihood ratio of positive test at 14.9 and 9.8 and of negative test at 0.07 and 0.07, respectively.
The Short Form of the Mini-Mental State Examination was a good screening test for dementia in older individuals followed in a memory clinic for a memory complaint. The next step should be the confirmation of its discriminative value in older primary care patients.
为了验证简易精神状态检查（MMSE）的简短形式（SMMSE）是否可作为在记忆诊所因记忆主诉而接受随访的老年门诊个体的痴呆筛查测试。
本前瞻性横断面研究共纳入 202 名认知正常个体、100 名轻度认知障碍患者和 304 名痴呆患者，这些患者均由初级保健医生因记忆主诉而被转诊至记忆诊所。他们被随机分为推导组（n=303）和验证组（n=303）。SMMSE 评分由 MMSE 的六个记忆项目构建而成，得分范围为 0 至 6（即最佳表现）。
推导组和验证组的受试者工作特征曲线下面积分别为 0.98 和 0.97，曲线之间无差异（P=0.254）。SMMSE 评分用于诊断临床诊断为痴呆的敏感性和特异性之间的截断值为≤4。SMMSE 在推导组和验证组中对痴呆的诊断性能均较高：敏感性分别为 93.1%和 93.8%，特异性分别为 93.8%和 90.5%，阳性预测值分别为 94.3%和 90.1%，阴性预测值分别为 92.5%和 94.0%，阳性检验的似然比分别为 14.9 和 9.8，阴性检验的似然比分别为 0.07 和 0.07。
简短形式的简易精神状态检查是在记忆诊所因记忆主诉而接受随访的老年个体的一种较好的痴呆筛查测试。下一步应该是确认其在老年初级保健患者中的鉴别价值。
