Liu H C, Teng E L, Lin K N, Hsu T C, Guo N W, Chou P, Hu H H, Cheng W N, Chiang B N
Neurological Institute, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Arch Neurol. 1994 Sep;51(9):910-5. doi: 10.1001/archneur.1994.00540210082016.
To examine the relation between performance on a dementia screening test and the demographic variables of age, education, gender, and urban vs rural residency.
Community survey with cluster sampling.
One urban and one rural community from each of four geographic regions in Taiwan, Republic of China.
A total of 5265 nondemented individuals approximately equally divided between men and women and between urban and rural residency with a range in age from 41 to 88 years and in education from 0 to 20 years.
Score on a Chinese adaptation of the Mini-Mental State Examination.
Lower test scores were associated with older age and less education. The decrease in score with age was faster among participants who had never attended school. Better performance by men and by urban residents was found only among participants with fewer than 6 years of schooling. In this group, the magnitudes of sex and residency differences were comparable among those subjects aged 41 to 64 years and those aged 65 to 88 years. Women who had never worked outside of the home performed poorer than those who had worked outside of the home.
The influence of educational background on test performance is most evident in individuals with less education. Commonly used dementia screening tests may be unfair to poorly educated individuals, especially women and rural residents. Efforts should be made to develop ecologically relevant cognitive tests for the intended study populations. To help distinguish test bias from different rates of cognitive decline, the study populations should include individuals in predementia age ranges.
探讨痴呆筛查测试表现与年龄、教育程度、性别以及城乡居住情况等人口统计学变量之间的关系。
采用整群抽样的社区调查。
中国台湾四个地理区域中的一个城市社区和一个农村社区。
共5265名无痴呆个体，男女比例大致相等，城乡居住情况也大致相同，年龄范围为41至88岁，教育程度从0至20年。
中文版简易精神状态检查表的得分。
测试得分较低与年龄较大和教育程度较低相关。从未上学的参与者中，得分随年龄的下降更快。仅在受教育年限少于6年的参与者中发现男性和城市居民表现更好。在这个群体中，41至64岁和65至88岁的受试者中，性别和居住情况差异的幅度相当。从未在家外工作的女性比曾在家外工作的女性表现更差。
教育背景对测试表现的影响在受教育程度较低的个体中最为明显。常用的痴呆筛查测试可能对受教育程度低的个体不公平，尤其是女性和农村居民。应努力为目标研究人群开发与生态相关的认知测试。为了有助于区分测试偏差和不同的认知衰退率，研究人群应包括处于痴呆前期年龄范围的个体。
