Mini-Mental State Examination: Avaliação dos Novos Dados Normativos no Rastreio e Diagnóstico do Défice Cognitivo

Abstract

RESUMOIntrodução: O Mini-Mental State Examination é o teste de rastreio de défice cognitivo/demência mais difundido. No nosso país têm-se utilizado pontuações de corte definidas por grupos de literacia, mas existem novas propostas sustentadas por estudos mais representativos. Propomo-nos confirmar a influência da idade e da escolaridade no desempenho, avaliar a capacidade discriminativa dos novos dados normativos e testar a acuidade diagnóstica das pontuações de corte validadas para o défice cognitivo ligeiro e para as formas mais prevalentes de demência. The Mini-Mental State Examination is the most commonly used cognitive screening test. In Portugal, the cut-off scores are defined according to literacy groups, but different proposals have been recommended by more representative studies. We therefore propose to confirm the influence of demographical variables, such as age and education, in the subject's performance; evaluating the discriminant ability of the new normative data; and to further examine the diagnostic acuity of the validated cut-off scoring for mild cognitive impairment and for the most prevalent types of dementia. Material and Methods: Our study includes 1 441 educated subjects, divided into seven subgroups: Mild cognitive impairment, Alzheimer's disease, frontotemporal dementia, vascular dementia, dementia with Lewy bodies, community-controls and memory cliniccontrols. Results: Altogether age and education explain 10.4% of the Mini-Mental State Examination results variance, with both variables contributing significantly to the results' prediction. The diagnostic acuity based on the most recent normative data was always higher than the one obtained through the validation cut-off scoring, revealing an overall excellent specificity (superior to 90%) and different sensitivity values: excellent for mild Alzheimer's disease (91%), good for dementia with Lewy Bodies (78%) and low for mild cognitive impairment (65%), frontotemporal dementia and vascular dementia (55%). Discussion and Conclusions:The performance on the Mini-Mental State Examination is influenced by age and education, supporting the use of normative data that consider those variables. With this approach, the Mini-Mental State Examination could be a sensitive and specific instrument for the Alzheimer's disease screening among all healthcare levels. Nevertheless, its diagnostic acuity is limited in other conditions frequently seen in memory clinics, such as Mild Cognitive Impairment and other types of dementia.

Rastreio cognitivo em estruturas residenciais para pessoas idosas no Concelho de Miranda do Corvo, Portugal

“…Concerning the second objective, the results of this study show that the only factor predicting the MMSE score was schooling. These results are in line with those found by Santana et al 58 where a significant positive correlation was found between MMSE and schooling (r = 0.24, p = 0.01). However, if we analyze the association between the variable with "cognitive / no cognitive impairment" and schooling, we can observe that people with over 11 years of schooling years have cognitive impairment.…”

Validation of the Portuguese version of Addenbrooke’s Cognitive Examination III in mild cognitive impairment and dementia

“…However, in comparison to other widely used screening tests -like the Mini-Mental State Examination (MMSE) with a sensitivity level for MCI of 64.6%, and the MoCA test with a sensitivity level of 84.1% -the sensitivity values obtained for different ACE-III cut-off points are encouraging. 14,18 Future studies must determine whether the specificity values found in our study are due to the characteristics of our MCI sample or to the specifications of the instrument.…”

Censo Das Pessoas Com Deficiências E as Suas Funcionalidades Na Cidade De Maracaí/Sp

“…O Instituto Brasileiro de Geografia e Estatística (IBGE) realizou pesquisas censitárias para inferir na composição populacional e dar um pressuposto para uma política mais igualitária, sendo no ano de 2010, a atualização dos dados colhidos no ano 2000, onde se obteve inúmeros dados, inclusive sobre pessoas com deficiências [7][8][9][10][11][12][13][14][15][16][17] .…”

“…Apresenta 9 itens que são pontuados de 0 a 2 pontos, totalizando 16 pontos, sendo o escore mais alto o melhor nível de equilíbrio e o menor, inversamente proporcional. C) Escala Mini Exame de Estado Mental 14,15,16 : é uma escala que faz a avaliação da cognição do participante. Possui 5 itens, podendo o participante, atingir até 5 pontos na orientação espacial, na orientação temporal e na atenção e cálculo; atingir no máximo 3 pontos na memória imediata e na memória de evocação e 9 pontos na linguagem, totalizando 30 pontos de pontuação máxima.…”