从55岁以上城乡居民MMSE得分特征上探讨其适用范围

目的 :探讨MMSE的适用人群及影响因素。方法 :通过随机整群分层抽样 ,对 4 92 1名 5 5岁或以上的西安市城乡居民进行MMSE测查。分析MMSE在不同人群中的得分特征对痴呆的阳性预测值和分析影响MMSE得分的因素。结果 :MMSE得分在不同年龄、不同文化程度、总体人群中都呈现负偏态 ,尖峭峰型分布。在年龄较轻 (70岁以下 )、文化程度偏高 (初中或以上 )的人群中偏态分布最明显 ,痴呆的检出率较低 ;而在年龄偏大 (70岁以上 ) ,文化程度偏低 (小学及以下 )的人群中接近正态分布 ,痴呆的检出率较高。年龄、性别、受教育年限、听力下降、日常生活能力对MMSE得分有显著影响。结论 :MMSE量表最适用于年龄偏大 (70岁以上 ) ,文化程度偏低 (小学或以下 )的人群 ,对痴呆的筛选能力大 ;而对于年龄偏小 ,文化程度偏高的人群 ,MMSE的鉴别筛选力较低。

The Suitable Application the MMSE on Old People in Urban and Rural Areas

Objective:To analyze the optimal application groups and influent factors of MMSE were studied. Methods:A total of 4921 old people aged 55 years and over were selected by means of randomized stratification cluster sampling from the urban and rural areas in Xi'an. The MMSE scores distribution and positive predictive values were analyzed among subjects of different ages and educational levels. Multiple stepwise regression method was used to evaluate significant variables. Results:MMSE scores showed a negative and cliff distributions for different ages, education levels, as well as for the whole sample. Moreover, these features were found to be most pronounced in relatively younger old subjects (less 70 years) with comparably higher educational levels (upper high school). Accordingly, the screening-out rates for dementia were higher among relatively older subjects with poor educational levels, when compared to younger and fairly well-educated subjects. Variables such as education, age, sex, hearing loss and daily functional abilities could significantly affect the MMSE score ( P <0.001). Conclusion:The MMSE scale can be best applied to older people (upper 70 years) with lower educational background (illiterate, elementary and below). Its performance as a screening instrument for dementia deteriorates significantly for younger subjects with higher educational levels.