Kim So Young, Lim Tae Sung, Lee Hyun Young, Moon So Young
Department of Neurology, School of Medicine, Ajou University, 5 San, Woncheon-dong, Yongtong-gu, Suwon-si, Kyunggi-do, 442-749, Republic of Korea.
Neurol Sci. 2014 Sep;35(9):1353-8. doi: 10.1007/s10072-014-1711-y. Epub 2014 Mar 19.
We aimed to evaluate whether the performance of the mini-mental state examination (MMSE) could identify risky mild cognitive impairment (MCI). We recruited 122 amnestic MCI-single domain (ASM), 303 amnestic MCI-multiple domains (AMM), and 94 non-amnestic MCI (NAM). Two-step cluster and linear discriminant analyses were used for identifying the clusters of the MMSE with age and education, as well as establishing prediction models for each cluster. Conversion into dementia was compared among clusters. Cluster analyses revealed the following three: cluster 1 = 205 AMM (100 %); cluster 2 = 61 NAM (33.3 %) and 122 ASM (66.7 %); and cluster 3 = 33 NAM (25.2 %) and 98 AMM (74.8 %). Cluster 3 showed a significantly lower ability with regards to orientation to time and place, registration of three words, attention/calculation, language, and copying interlocking pentagons, than clusters 1 and 2. However, for delayed recall, cluster 1 was significantly more impaired than cluster 2. Patients in the cluster 1 showed the most common conversion into dementia [odds ratio (OR) = 2.940 vs. cluster 2, OR = 2.271 vs. cluster 3]. This study showed that clustering by performance in MMSE could help define groups at higher risk for conversion to dementia. Therefore, MMSE can be considered as a promising screening tool including subtyping for MCI when detailed neuropsychological tests are not feasible.
我们旨在评估简易精神状态检查表（MMSE）的表现能否识别有风险的轻度认知障碍（MCI）。我们招募了122例遗忘型MCI-单领域（ASM）患者、303例遗忘型MCI-多领域（AMM）患者和94例非遗忘型MCI（NAM）患者。采用两步聚类分析和线性判别分析来确定MMSE与年龄和教育程度的聚类情况，并为每个聚类建立预测模型。比较各聚类之间向痴呆症的转化情况。聚类分析揭示了以下三种情况：聚类1 = 205例AMM（100%）；聚类2 = 61例NAM（33.3%）和122例ASM（66.7%）；聚类3 = 33例NAM（25.2%）和98例AMM（74.8%）。与聚类1和聚类2相比，聚类3在时间和地点定向、三个单词的记忆、注意力/计算、语言以及临摹相互嵌套的五边形方面的能力明显较低。然而，在延迟回忆方面，聚类1比聚类2受损明显更严重。聚类1中的患者向痴呆症转化最为常见[比值比（OR）= 2.940，相对于聚类2，OR = 2.271，相对于聚类3]。本研究表明，根据MMSE表现进行聚类有助于确定转化为痴呆症风险较高的群体。因此，当详细的神经心理学测试不可行时，MMSE可被视为一种有前景的筛查工具，包括对MCI进行亚型分类。
