치매와 우울증의 감별을 위한 한국어판 간이정신상태검사의 차별문항 추출
Measuring Cognition in Elderly People : Mini-Mental State Examination-Korean Version
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives：The Mini-Mental State Examination is arguably the most widely used screening measure for cognitive impairment. The aims of this study are to evaluate the psychometric properties of the Mini-Mental State Examination-Korean Version(MMSE-KC) as a quantitative measure of cognitive ability. Methods：Data were analyzed from a total of 312 participants age 65 or older from cross-sectional community-ba-sed study, which were collected about demographic information and individual item responses to MMSE-KC. Item response theory was used to analyze individual items. Results：Comparison of the data with a unidimensional 2-parameter model indicated that the total score obtained by summing across all items yields a reliable(0.78) quantitative estimate of global cognitive ability. All items fit the model and together spanned a range of difficulty(threshold parameter) from -3.86(easier) to 1.15(more difficult) logits, and discrimination(slope parameter) from 0.55 to 8.6 logits. The items about ‘recall of three words’ and ‘attention’ were the most difficult items and have most powerful discrimination parameter. Copying pentagons and time(year) orientation were more difficult than the other items. The patients with dementia showed differential item functioning such items as orientation to place, the last two items of ‘recall of three words’, the last two items of ‘attention’, and ‘three stage command’. Conclusion：The MMSE-KC can provide a reliable and valid quantitative estimate of cognitive ability. More attention should be paid to the difficult items like ‘recall of three words’ and ‘attention’ for the discrimination of dementia from non-dementia people.
Abstract
Objectives：The Mini-Mental State Examination is arguably the most widely used screening measure for cognitive impairment. The aims of this study are to evaluate the psychometric properties of the Mini-Mental State Examination-Korean Version(MMSE-KC) as a quantitative measure of cognitive ability. Methods：Data were analyzed from a total of 312 participants age 65 or older from cross-sectional community-ba-sed study, which were collected about demographic information and individual item responses to MMSE-KC. Item response theory was used to analyze individual items. Results：Comparison of the data with a unidimensional 2-parameter model indicated that the total score obtained by summing across all items yields a reliable(0.78) quantitative estimate of global cognitive ability. All items fit the model and together spanned a range of difficulty(threshold parameter) from -3.86(easier) to 1.15(more difficult) logits, and discrimination(slope parameter) from 0.55 to 8.6 logits. The items about ‘recall of three words’ and ‘attention’ were the most difficult items and have most powerful discrimination parameter. Copying pentagons and time(year) orientation were more difficult than the other items. The patients with dementia showed differential item functioning such items as orientation to place, the last two items of ‘recall of three words’, the last two items of ‘attention’, and ‘three stage command’. Conclusion：The MMSE-KC can provide a reliable and valid quantitative estimate of cognitive ability. More attention should be paid to the difficult items like ‘recall of three words’ and ‘attention’ for the discrimination of dementia from non-dementia people.
참고문헌 (23)
- Thomas AJ, "Depression and cognition in older adults", Curr Opin Psychiatry, 21, pp.8~13 (2008)
- Emery VO, "Update on the dementia spectrum of depression", Am J Psychiatry, 149, pp.305~317 (1992)
- Lockwood KA, "Subtypes of cognitive impairment in depressed older adults", Am J Geriatr Psychiatry, 8, pp.201~208 (2000)
- Benedict KB, "Dementia and depression in the elderly: a framework for addressing difficulties in differential diagnosis", Clin Psychol Rev, 10, pp.513~537 (1990)
- Brodaty H, "Prognosis of depression in the elderly. A com-parison with younger patients", Br J Psychiatry, 163, pp.589~596 (1993)
- Katz IR, "Diagnosis and treatment of depression in patients with Alzheimer’s disease and other dementias", J Clin Psychiatry, 59, pp.38~44 (1998)
- Korczyn AD, "Depression and dementia", J Neurol Sci, 283, pp.139~142 (2009)
- Alexopoulos GS, "The course of geriatric depression with “reversible dementia”: a controlled study", Am J Psychiatry, 150, pp.1693~1699 (1993)
- Reding M, "Depression in patients referred to a dementia clinic. A three-year prospective study", Arch Neurol, 42, pp.894~896 (1985)
- Saez-Fonseca JA, "Long-term outcome of depressive pseudodementia in the elderly", J Affect Disord, 101, pp.123~129 (2007)
- Becker JT, "Depressed mood is not a risk factor for incident dementia in a community-based cohort", Am J Geriatr Psychiatry, 17, pp.653~663 (2009)
- Reys BN, "Brief cognitive evaluation and diagnosis of dementia, depression, and psychosis in the elderly", Rev Assoc Med Bras, 52, pp.401~404 (2006)
- Stoudemire A, "Neuropsychological and biomedical assessment of depression-dementia syndromes", J Neuropsychiatry Clin Neurosci, 1, pp.347~361 (1989)
- 이동영, "Mini-Mental State Examination의 한국 노인 정상규준 연구", 신경정신의학, 41(3) (2002), 대한신경정신의학회
- Folstein MF, "“Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
- 조맹제, "한국어판 Composite International Diagnostic Interview(K-CIDI)의 개발", 신경정신의학, 41(1) (2002), 대한신경정신의학회
- Chang CH, "Item response theory and its applications to patient-reported outcomes measurement", Eval Health Prof, 28, pp.264~282 (2005)
- Baker FB, "The basics of item response theory. 2nd ed" (2001), ERIC Clearinghouse on Assessment and Evaluation
- 장성만, "한국인의 우울증 진단기준의 특성", 신경정신의학, 46(5), pp.447~452 (2007), 대한신경정신의학회
- Welsh K, "Detection of abnormal memory decline in mild cases of Alzheimer’s disease using CERAD neuropsychological measures", Arch Neurol, 48, pp.278~281 (1991)
- Knopman DS, "A verbal memory test with high predictive accuracy for dementia of the Alzheimer type", Arch Neurol, 46, pp.141~145 (1989)
- Speedie L, "Confrontation naming deficit in dementia of depression", J Neuropsychiatry Clin Neurosci Winter, 23, pp.59~63 (1990)
- Benjamin JS, "Kaplan and Sadocks Comprehensive textbook of psychiatry" (2009), LLW