運用簡易智能測驗協助篩檢老年失智症

Screening for Early Onsets of Dementia: An Evaluation of the Mini-Mental State Examination

簡易智能測驗（Mini-Mental State Examination；MMSE）是認知評鑑的常規檢查工具，量表內容可分為定向力、訊息登錄、注意力與計算、短期記憶及語言能力。對於簡易智能測驗成績偏低一般反應出記憶力改變，而可視為老年失智症的一種前兆。本研究以某老人養護中心住民資料為例，主要以統計方法探討有無老年失智症與其所對應之簡易智能測驗成績的關係；並且建立簡易智能測驗成績門檻值用於分類有無老年失智症及說明該門檻值的解釋意義。本研究發現，運用簡易智能測驗分數於老年失智症的前兆篩檢，其ROC-曲線下面積（AUROC）高達0.848；當簡易智能測驗分數門檻值設定在16~17分，其所對應之敏感度高達91.7％、特異度亦達72.7％。本研究主要運用簡易智能測驗量表協助進行老年失智症評估篩檢，期使家中有年長者之家庭能隨時對家中長者進行此簡易智能評估，做到早期發現早期治療，避免造成一個家庭的失序。

Folstein et al.’s Mini-Mental State Examination (MMSE) is cognitive impairment. Low scores on the MMSE reflect possible changes in memory, a common predictor of the onset of dementia. This study attempted to use statistical methods to systematically investigate the relationship between dementia and the respective intelligence scores using data collected from residents of a long-term care giving facility. We also attempted to elaborate on the meaning of the cutoff score for screening for cognitive impairment. Results indicated MMSE scores as the most discriminatory of all measures used, with 0.848 falling beneath the AUROC curve. A cutoff score set at 16 to 17 demonstrates 91.7％ sensitivity and 72.7％ specificity when predicting significant cognitive impairment. It is advised that elders be given simple assessments of intelligence. Upon detection, early symptoms of dementia should be treated as soon as possible.