Fillenbaum G G, Wilkinson W E, Welsh K A, Mohs R C
Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC.
Arch Neurol. 1994 Sep;51(9):916-21. doi: 10.1001/archneur.1994.00540210088017.
To identify minimal sets of Mini-Mental State Examination (MMSE) items that can distinguish normal control subjects from patients with mild Alzheimer's disease (AD), patients with mild from those with moderate AD, and those with moderate from those with severe AD.
Two randomly selected equivalent half samples. Results of logistic regression analysis from data from the first half of the sample were confirmed by receiver operating characteristic curves on the second half.
Memory disorders clinics at major medical centers in the United States affiliated with the Consortium to establish a Registry for Alzheimer's Disease (CERAD).
White, normal control subjects (n = 412) and patients with AD (n = 621) who met CERAD criteria; nonwhite subjects (n = 165) and persons with missing data (n = 27) were excluded.
Three four-item sets of MMSE items that discriminate, respectively, (1) normal controls from patients with mild AD, (2) patients with mild from those with moderate AD, and (3) patients with moderate from those with severe AD.
The MMSE items discriminating normal controls from patients with mild AD were day, date, recall of apple, and recall of penny; those discriminating patients with mild from those with moderate AD were month, city, spelling world backward, and county, and those discriminating patients with moderate from those with severe AD were floor of building, repeating the word table, naming watch, and folding paper in half. Performance on the first two four-item sets was comparable with that of the full MMSE; the third set distinguished patients with moderate from those with severe AD better than chance.
A minimum set of MMSE items can effectively discriminate normal controls from patients with mild AD and between successive levels of severity of AD. Data apply only to white patients with AD. Performance in minorities, more heterogeneous groups, or normal subjects with questionable cognitive status has not been assessed.
确定简易精神状态检查表（MMSE）项目的最小集合，以区分正常对照受试者与轻度阿尔茨海默病（AD）患者、轻度AD患者与中度AD患者以及中度AD患者与重度AD患者。
两个随机选取的等效半样本。对样本前半部分数据进行逻辑回归分析的结果，通过后半部分的受试者工作特征曲线得到证实。
美国主要医疗中心与阿尔茨海默病注册协作组（CERAD）相关的记忆障碍诊所。
符合CERAD标准的白人正常对照受试者（n = 412）和AD患者（n = 621）；排除非白人受试者（n = 165）和数据缺失者（n = 27）。
三组四项MMSE项目集合，分别用于区分（1）正常对照与轻度AD患者，（2）轻度AD患者与中度AD患者，（3）中度AD患者与重度AD患者。
区分正常对照与轻度AD患者的MMSE项目为日期、星期、苹果回忆和便士回忆；区分轻度AD患者与中度AD患者的项目为月份、城市、倒拼单词和所在县；区分中度AD患者与重度AD患者的项目为楼层、重复单词“table”、说出手表名称和将纸对折。前两组四项集合的表现与完整MMSE相当；第三组能较好地区分中度与重度AD患者。
MMSE项目的最小集合可有效区分正常对照与轻度AD患者以及AD不同严重程度级别。数据仅适用于白人AD患者。未评估少数族裔、更多样化群体或认知状态存疑的正常受试者的情况。
