期刊
JOURNAL OF PSYCHIATRIC RESEARCH
卷 43, 期 4, 页码 464-470出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jpsychires.2008.06.002
关键词
Cognition; Screening scale; Late-life depression; Dementia; MMSE; DRS
类别
资金
- US PHS [MH 37869, MH 43832, MH 69430, MH 71944, MH 72947]
- John A Hartford Center of Excellence in Geriatric Psychiatry at Pittsburgh
- NATIONAL INSTITUTE OF MENTAL HEALTH [K24MH069430, R01MH043832, R37MH043832, P30MH071944, R01MH037869, R01MH072947] Funding Source: NIH RePORTER
Background: The Mini Mental State Examination (MMSE) is frequently used to assess cognition in studies of late-life depression (LLD). However, its sensitivity and specificity in this population are largely unknown. We undertook an analysis of subjects with LLD and hypothesized that: (1) at the traditional cutoff of 24, the MMSE would have low sensitivity in the detection of cognitive impairment; (2) increasing the cutoff score would improve this sensitivity at the expense of a minimal reduction in specificity. Methods: We analyzed the MMSE scores of 447 non-demented subjects with LLD using the Dementia Rating Scale (DRS) as the gold standard for cognitive function. Results: Using the DRS raw total cutoff of 132 as the gold standard, the MMSE at a cutoff of 24 has a sensitivity of 8.0% and a specificity of 99.4% in detecting cognitively impaired depressed elders. A. receiver operating characteristic curve demonstrates that with an MMSE cutoff of 27 instead of 24, its sensitivity more than quadruples and increases to 37.5% while its specificity decreases minimally from 99.4% to 91.3%. Conclusions: In our sample almost all of those classified as cognitively impaired by the DRS are mislabelled its cognitively intact by the MMSE. By using a higher cutoff score, the sensitivity can be increased with a minimal reduction in specificity. Our findings have significant implications for those who study or treat persons with LLD or other neuropsychiatric disorders. (C) 2008 Elsevier Ltd. All rights reserved.
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