简易精神状态检查适用人群及影响因素

Applicability of MMSE in West China: who is more suitable

目的 :根据简易精神状态检查 (MMSE)在大样本人群中的测试结果分析 ,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 492 1名 5 5岁或以上的西安市城乡居民进行MMSE测查。分析MMSE得分在不同年龄 ,不同文化程度以及总体人群中的第 10百分数、中位数、偏度、峰度以及对痴呆的阳性预测值。并用多元逐步回归法分析MMSE得分的影响因素。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 )的人群中偏性分布最明显 ,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。文化程度、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 (P <0 0 0 1)。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。实践中应根据具体研究目的选用适宜量表 ,并灵活掌握分界值 。

Objective: To find out who is more suitable to be screened by MMSE (mini-mental state examination) Method: A total of 4921 persons aged 55 or above were collected by stratification cluster sampling for urban and rural areas of Xi'an They were screened by MMSE According to different age and education levels, the tenth percentage, median, skewness and kurtosis, and the positive predict value were calculated Results: MMSE scores showed a negative and cliff distributions whether among groups of different education level, among different age groups or in the total sample Moreover, these features was more obvious in relatively younger people (less than 70 years) with higher education level (high school or college), while in those aged more than 70 years with poor education (primary school or illiterate), the distribution of MMSE score was close to normal Consequently, the rates screened out by MMSE was higher in older and poor educated people than in those younger with higher education Multiple regression showed that education level, age, sex, lose of hearing, activity in daily life were factors having influence on score of MMSE Conclusion: In screening dementia, MMSE is more suitable for poor educated older people (older than 70)