BACKGROUND:Several studies have identified moderate reliability and validity for the Mini-Mental State Examination (MMSE). Some researchers showed the superiority of other dementia screening tests over the MMSE considering the test quality criteria. The aim of this study was the evaluation of MMSE, especially in the area of geriatrics. PATIENTS AND METHODS:MMSE and DemTect were carried out with 154 geriatric patients: 71 persons without cognitive impairment and 83 persons without delirium showed cognitive impairments as revealed by the DemTect. In addition, we also applied the Clock-Drawing-Test (CDT), Reisberg-Scale, Geriatric Depression-Scale (GDS, 15-item version) and the Confusion-Assessment-Method (CAM). RESULTS:According to the multitrait-multimethod approach, MMSE's convergent and divergent validity is similar to that of the DemTect. Both tests correlate only moderately with Spearman (r = 0.609) and revealed similar results for dementia in 57.1 % of the patients. MMSE showed low reliability and moderate reliability (Cronbach's α = 0.82) when ten items with low discriminatory power were excluded from the total test score. Difficulty of all items is only moderate (p = 0.86) and only eight items of the MMSE showed good test difficulty. CONCLUSION:All in all, DemTect and MMSE are not interchangeable. The MMSE estimates the average cognitive impairment of patients as considerably less pronounced than the DemTect. MMSE is, thus, not an instrument that would be recommended for the identification of mild cognitive impairment. In this case, tests with higher reliability and validity should be used.

译文

背景:多项研究已确定中度精神状态检查(MMSE)的中等信度和效度。考虑到测试质量标准,一些研究人员证明了其他痴呆筛查测试优于MMSE。这项研究的目的是评估MMSE,尤其是在老年医学领域。
患者和方法:对154名老年患者进行了MMSE和DemTect:DemTect揭示了71名无认知障碍的人和83名无83妄的人表现出认知障碍。此外,我们还应用了时钟绘图测试(CDT),Reisberg量表,老年抑郁量表(GDS,15个项目)和混淆评估方法(CAM)。
结果:根据多特征-多方法方法,MMSE的收敛效度和发散效度与DemTect相似。两项测试与Spearman的相关性均只有中等程度的相关性(r = 090.609),并且在57.1 patients%的患者中显示出痴呆症的相似结果。当从总测试成绩中排除十项具有较低辨别力的项目时,MMSE表现出较低的可靠性和中等的可靠性(Cronbach'sα= 0.82)。所有项目的难度仅为中等(p = 0.86),只有MMSE的八个项目显示出良好的测试难度。
结论:总而言之,DemTect和MMSE不可互换。 MMSE估计患者的平均认知障碍程度不如DemTect明显。因此,MMSE不是推荐用于识别轻度认知障碍的工具。在这种情况下,应使用具有更高可靠性和有效性的测试。

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