简易智能精神状态检查量表检测老年期痴呆患者的应用探讨

Discussion on Application of MMSE for Senile Dementia Patients

目的研究简易智能精神状态检查量表(mini mentalstateexamination,MMSE)的人群分布特征、临床适用性、痴呆筛查的界定值及痴呆早中期的分界值。方法采用随机分层抽样方式,对北京城乡40岁及以上常模、痴呆及易混淆疾病人群进行MMSE调查研究及统计分析。结果MMSE检测结果表明,在城乡常模人群间差异有显著性,其分值随年龄增长而下降,文化程度越高分值越高;痴呆筛查的界定值文盲组≤24分、文化组(初小及以上)≤26分,痴呆早中期分界值文盲组为17分、文化组(初小及以上)为19分。结论MMSE涵盖的认知项目广泛,操作简单方便,筛查痴呆敏感度较高,适于临床广泛应用,但MMSE判断的认知功能下降是非特异性的,受许多疾病及意识、精神状态干扰,故应结合临床综合判断。

Objective To investigate the application of mini-mental state examination(MMSE) on the population distribution, clinical suitability, cutoff score for screening and distinguishing mild from moderate dementia. Methods Subjects including 40- year old normal subjects, dementia, and obscure disease crowd in urban and rural areas in Beijing were investigated with MMSE. Results The remarkable difference exists among the normal crowds in the urban and (rural) areas, with growth of the age the MMSE score dropped, the higher education the high score was the cutoff score checked dementia, illiterate group was ≤24 points, cultural group (primary school-) was ≤ 26 points,the cutoff score of dementia between mild and moderate, illiterate group was 17 points, the cultural group (primary school-) was 19 points. Conclusions The MMSE contains wildly extensive cognitive project, it is simple and convenient to operate, and has tally sensitivity to sift and check the dementia, suitable for general clinical application,since MMSE is not peculiar on judging cognitive function decline, interfered by various consciousness, and spiritual situations.It should apply with synthesizing judge and diagnosis clinically.