Quaranta Davide, L'Abbate Federica, Pelosi Annalisa, Arighi Andrea, Asoni Gesuina, Bagattini Chiara, Bessi Valentina, Bonanni Laura, Bortoletto Marta, Bruni Amalia Cecilia, Cagnin Annachiara, Cappa Stefano F, Giubilei Franco, Guarino Maria, Iavarone Alessandro, Isella Valeria, Luca Antonina, Monastero Roberto, Pellegrini Francesca Ferrari, Perini Marta, Piccoli Tommaso, Rainero Innocenzo, Tedeschi Gioacchino, Marra Camillo, Caffarra Paolo
Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy.
Neurol Sci. 2025 Apr;46(4):1617-1627. doi: 10.1007/s10072-024-07863-4. Epub 2024 Dec 4.
The Italian telephone-based Mini-Mental State Examination (Itel-MMSE) is considered a very easy tool for screening individuals with dementia, gained importance during COVID-19, but lacks validation and faces a ceiling effect.
In the present study, we conducted a study standardizing and validating it, establishing cut-off values for two versions.
Across 24 Italian sites, 707 healthy individuals (50-89 years, men: 268, women: 439) with diverse educational levels (3-24 years) were recruited. Subjects met criteria for normal conditions investigated through a semi-structured interview covering neurological, psychiatric, general medical, and psychopharmacological history. Two test versions were created to assess test-retest reliability at 45-day intervals. We also enrolled 187 subjects with Mild Cognitive Impairment (MCI) and 181 with Alzheimer's Disease (AD) for validation. The raw scores obtained on both versions of Itel-MMSE were set as dependent variables in linear regression models that included age, education, and gender as independent variables. RESULTS : Mean raw Itel-MMSE1 score was 20.82 (range: 13-22). Multiple linear regression demonstrated significant effects of sociodemographic variables for age and education, establishing a new cut-off ≥ 18.49. Mean raw Itel-MMSE2 score was 20.97 (range: 10-22), with a new cut-off ≥ 18.45. Validation showed high informative values, with areas under the curve (AUCs) for MCI and AD conditions and both versions (Itel-MMSE1: MCI AUC = 0.801, AD AUC = 0.907; Itel-MMSE2: MCI AUC = 0.827, AD AUC = 0.977).
The Itel-MMSE proves valuable as a screening method for detecting and monitoring dementia in remote phone screenings, with different cut-offs aiding MCI patient identification in clinical settings.
基于电话的意大利简易精神状态检查表（Itel-MMSE）被认为是一种筛查痴呆症患者的非常简便的工具，在新冠疫情期间变得尤为重要，但缺乏有效性验证且存在天花板效应。
在本研究中，我们对其进行标准化和有效性验证研究，为两个版本确定临界值。
在意大利的24个地点，招募了707名健康个体（年龄50 - 89岁，男性268名，女性439名），他们的教育水平各不相同（3 - 24年）。通过涵盖神经、精神、普通医学和精神药理学病史的半结构化访谈，受试者符合正常状况标准。创建了两个测试版本，以评估每隔45天的重测信度。我们还纳入了187名轻度认知障碍（MCI）患者和181名阿尔茨海默病（AD）患者进行有效性验证。将Itel-MMSE两个版本获得 的原始分数作为线性回归模型中的因变量，该模型将年龄、教育程度和性别作为自变量。结果：Itel-MMSE1的平均原始分数为20.82（范围：13 - 22）。多元线性回归表明社会人口统计学变量对年龄和教育程度有显著影响，确定了一个新的临界值≥18.49。Itel-MMSE2的平均原始分数为20.97（范围：10 - 22），新的临界值≥18.45。有效性验证显示出高信息价值，MCI和AD状况以及两个版本的曲线下面积（AUC）分别为（Itel-MMSE1：MCI的AUC = 0.801，AD的AUC = 0.907；Itel-MMSE2：MCI的AUC = 0.827，AD的AUC = 0.977）。
Itel-MMSE被证明是一种有价值的筛查方法，可用于在远程电话筛查中检测和监测痴呆症，不同的临界值有助于在临床环境中识别MCI患者。
