Baek Min Jae, Park Young Ho, Kim SangYun
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2025 Sep 15;40(36):e235. doi: 10.3346/jkms.2025.40.e235.
This study aimed to compare the diagnostic utility of the Mini-Mental State Examination-2 (MMSE-2) and the Korean version of the Mini-Mental State Examination (K-MMSE) in differentiating normal cognitive aging, mild cognitive impairment (MCI), and Alzheimer's disease (AD) within a Korean population.
A total of 226 individuals with MCI, 97 with AD, and 91 cognitively healthy older adults were recruited. Participants underwent the MMSE-2, K-MMSE, and a comprehensive neuropsychological assessment battery. Discriminant analysis was employed to compare the classification accuracy of each tool, while sensitivity and specificity were evaluated using receiver operating characteristic (ROC) curve analysis.
Discriminant analysis revealed that the MMSE-2 accurately classified 71.1% of participants, including 68.6% of MCI patients, 78.4% of AD patients, and 72.5% of healthy controls. In contrast, the K-MMSE achieved an overall classification accuracy of 67.9%, with 83.6% accuracy for MCI, 68.0% for AD, and 28.6% for healthy controls. ROC analysis indicated that the area under the curve (AUC) values for the MMSE-2: Brief Version (BV) (0.708), Standard Version (SV) (0.720), and Expanded Version (EV) (0.728) surpassed that of the K-MMSE (0.703) in distinguishing healthy controls from MCI patients. However, the K-MMSE (AUC = 0.936) demonstrated superior performance compared to the MMSE-2:BV (0.930), MMSE-2:SV (0.925), and MMSE-2:EV (0.921) in differentiating MCI from AD.
The MMSE-2:SV and MMSE-2:EV exhibit greater sensitivity in detecting cognitive impairment between normal aging and MCI. Conversely, the MMSE-2:BV and K-MMSE demonstrate superior sensitivity in distinguishing between MCI and AD. These findings underscore the importance of selecting an appropriate cognitive assessment tool based on specific diagnostic objectives and clinical contexts.
本研究旨在比较简易精神状态检查表第二版（MMSE - 2）和韩国版简易精神状态检查表（K - MMSE）在区分韩国人群中的正常认知老化、轻度认知障碍（MCI）和阿尔茨海默病（AD）方面的诊断效用。
共招募了226名MCI患者、97名AD患者和91名认知健康的老年人。参与者接受了MMSE - 2、K - MMSE和全面的神经心理学评估量表测试。采用判别分析比较每种工具的分类准确性，同时使用受试者工作特征（ROC）曲线分析评估敏感性和特异性。
判别分析显示，MMSE - 2准确分类了71.1%的参与者，其中包括68.6%的MCI患者、78.4%的AD患者和72.5%的健康对照。相比之下，K - MMSE的总体分类准确率为67.9%，MCI的准确率为83.6%，AD的准确率为68.0%，健康对照的准确率为28.6%。ROC分析表明，在区分健康对照与MCI患者方面，MMSE - 2的简易版（BV）（0.708）、标准版（SV）（0.720）和扩展版（EV）（0.728）的曲线下面积（AUC）值超过了K - MMSE（0.703）。然而，在区分MCI与AD方面，K - MMSE（AUC = 0.936）表现优于MMSE - 2的BV版（0.930）、MMSE - 2的SV版（0.925）和MMSE - 2的EV版（0.921）。
MMSE - 2的SV版和MMSE - 2的EV版在检测正常老化与MCI之间的认知障碍方面表现出更高的敏感性。相反，MMSE - 2的BV版和K - MMSE在区分MCI与AD方面表现出更高的敏感性。这些发现强调了根据特定诊断目标和临床背景选择合适的认知评估工具的重要性。
