Central Virginia Veterans Affairs Health Care System.
Department of Psychology.
Rehabil Psychol. 2022 Nov;67(4):597-601. doi: 10.1037/rep0000465. Epub 2022 Sep 12.
PURPOSE/OBJECTIVE: The Modified Mini-Mental State Exam (3MS) is a brief, widely used cognitive screening tool. This study examined differences in 3MS performance between Black and White individuals undergoing acute brain injury rehabilitation.
RESEARCH METHOD/DESIGN: Participants were Black (44.1%; = 78) and White (55.9%; = 99) individuals admitted over a 2-year period to inpatient rehabilitation for an acute neurological injury or illness at a major, urban mid-Atlantic medical center. An attending psychologist administered the 3MS during assessment at admission, and demographic and injury-related information was extracted from electronic medical records.
While there were no significant racial differences in the subsamples' gender, employment status, marital status, years of education, or days on the rehabilitation unit, Black participants were older and had a higher proportion of focal injuries or stroke. There were no significant racial differences in 3MS total scores. At the item level, Black participants scored lower on abstract reasoning, repetition, visuospatial construction, and comprehension. When adjusting for age and type of injury, significant differences remained in repetition and comprehension. The 3MS's internal consistency was adequate and comparable across races, as were item-total correlations, with the exception of White participants having a larger item-total correlation for the basic attention item.
CONCLUSIONS/IMPLICATIONS: These findings underscore a point of caution about interpreting the results of a cognitive screening measure like the 3MS without the context of an individual's neurological history and race. Black individuals might be at risk for being inappropriately screened to be cognitively impaired, and some level of racial sensitivity should be taken at the item level for repetition and comprehension constructs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
目的/目标：改良的简易精神状态检查（3MS）是一种简短的、广泛使用的认知筛查工具。本研究考察了在接受急性脑损伤康复治疗的黑人和白人个体中，3MS 表现的差异。
研究方法/设计：参与者为 2 年内入住一家主要城市大西洋中部医疗中心接受急性神经损伤或疾病住院康复治疗的黑人和白人个体（黑人占 44.1%，=78；白人占 55.9%，=99）。一名主治心理学家在入院评估时进行了 3MS 测试，并从电子病历中提取了人口统计学和损伤相关信息。
尽管在亚组的性别、就业状况、婚姻状况、受教育年限或在康复病房的天数方面没有明显的种族差异，但黑人参与者年龄更大，局灶性损伤或中风的比例更高。3MS 总分在种族间没有显著差异。在项目层面上，黑人参与者在抽象推理、重复、视觉空间结构和理解方面的得分较低。在调整年龄和损伤类型后，重复和理解方面仍存在显著差异。3MS 的内部一致性在各种族中是足够的且相当的，项目与总分的相关性也是如此，除了白人参与者在基本注意力项目上的项目与总分的相关性更大。
结论/意义：这些发现强调了在没有个体神经病史和种族背景的情况下，解释认知筛查测量（如 3MS）结果时需要谨慎。黑人个体可能面临被不恰当地筛查为认知受损的风险，在重复和理解结构方面，应该在项目层面上考虑一定程度的种族敏感性。
