치매선별검사로서 K-MMSE의 타당도 연구: 종합적인 신경심리학적 평가와의 비교
A Validity Study of K-MMSE as a Screening Test for Dementia: Comparison Against a Comprehensive Neuropsychological Evaluation
2
조회
0
다운로드
21
인용
0
참고문헌
키워드
초록
Although the Korean-Mini Mental Status Examination (K-MMSE) has been widely used for screening dementia in clinics and other community settings, there has been little investigation into the validity of the K-MMSE. The present study was conducted to examine the validity of the K-MMSE as a dementia screening tool compared against a comprehensive neuropsychological evaluation. Methods: The subjects were 707 outpatients (261 men, 446 women;mean age=70.3±6.3 yr, mean education= 6.3±5.1 yr) who visited the neurology or psychiatry department with complaints of cognitive dysfunction. They were given the K-MMSE and a comprehensive neuropsychological test battery (Seoul Neuropsychological Screening Battery,SNSB). The subjects were classified into ‘‘Cognitive Impairment’’ and ‘‘No Cognitive Impairment’’groups based on the SNSB as well as the K-MMSE. Results: The agreement between classification based on the K-MMSE and the SNSB was examined. The sensitivity of K-MMSE for detecting cognitive impairments was 80.3% and the specificity was 70.3% (Positive predictive value 90.4%; Negative predictive value 50.7%). The false-positive rate was found to be higher for the subjects with low education. The majority of the subjects in the false-negative group showed prominent frontal/executive dysfunctions as well as memory impairment. Conclusions:These results showed that K-MMSE has high positive- and negative-false rates and a low negative predictive power. They suggest that the K-MMSE should be given with memory and frontalexecutive function tests for improving screening accuracy for dementia.
Abstract
Although the Korean-Mini Mental Status Examination (K-MMSE) has been widely used for screening dementia in clinics and other community settings, there has been little investigation into the validity of the K-MMSE. The present study was conducted to examine the validity of the K-MMSE as a dementia screening tool compared against a comprehensive neuropsychological evaluation. Methods: The subjects were 707 outpatients (261 men, 446 women;mean age=70.3±6.3 yr, mean education= 6.3±5.1 yr) who visited the neurology or psychiatry department with complaints of cognitive dysfunction. They were given the K-MMSE and a comprehensive neuropsychological test battery (Seoul Neuropsychological Screening Battery,SNSB). The subjects were classified into ‘‘Cognitive Impairment’’ and ‘‘No Cognitive Impairment’’groups based on the SNSB as well as the K-MMSE. Results: The agreement between classification based on the K-MMSE and the SNSB was examined. The sensitivity of K-MMSE for detecting cognitive impairments was 80.3% and the specificity was 70.3% (Positive predictive value 90.4%; Negative predictive value 50.7%). The false-positive rate was found to be higher for the subjects with low education. The majority of the subjects in the false-negative group showed prominent frontal/executive dysfunctions as well as memory impairment. Conclusions:These results showed that K-MMSE has high positive- and negative-false rates and a low negative predictive power. They suggest that the K-MMSE should be given with memory and frontalexecutive function tests for improving screening accuracy for dementia.
참고문헌 (17)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders, Fourth Edition (DSM-IV)" (1994), American Psychiatric Association
- Cummings JL, "Dementia: a clinical approach. (2nd ed.)" (1992), Butterworth-Heinemann
- Chin JH, "Neuropsychological Assessment. In: Dementia: A clinical approach", pp.75~95 (2006), Academia Publishing Co
- Folstein MF, "‘‘Mini-Mental Sate’’: a practical method for grading the cognitive state of patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
- Lancu I, "The minimental state examination: an up-to-date review", Harefuah, 145, pp.687~690 (2006)
- Bondi MW, "The neuropsychology of dementia. In: Neuropsychological assessment of neuropsychiatric disorders", pp.164~199 (1996), Oxford University Press
- Kang Y, "A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients", J Korean Neurol Assoc, 15, pp.300~307 (1997)
- Park JH, "Standardization of Korean of the Mini-Mental State Examination (MMSE-K) for use in the elderly. Part II. Diagnostic Validity", J Korean Neuropsychiatr Assoc, 28, pp.508~513 (1989)
- Nelson A, "Bedside cognitive screening instruments. A critical assessment", J Nerv Ment Dis, 174, pp.73~82 (1986)
- 강연욱, "K-MMSE(Korean-Mini Mental State Examination)의 노인 규준 연구", 한국심리학회지:일반, 25(2), pp.1~12 (2006), 한국심리학회
- Fillenbaum GG, "Relation of health and demographic characteristics to Mini-Mental State Examination score among community residents", Psychol Med, 18, pp.719~726 (1988)
- O’Conner DW, "The influence of education, social class and sex on Mini-Mental State score", Psychol Med, 19, pp.771~776 (1989)
- Kang Y, "Seoul Neuropsychological Screening Battery (SNSB)" (2003), Human Brain Research & Consulting Co
- O’Conner DW, "The reliability and validity of the Mini-Mental State in a British community survey", J Psychiatr Res, 23, pp.87~96 (1989)
- Tombaugh TN, "The mini-mental state examination: A comprehensive review", J Am Geriatr Soc, 40, pp.922~935 (1992)
- Axelrod BN, "Sensitivity of the Mini-Mental State Examination to frontal lobe dysfunction in normal aging", J Clin Psychol, 48, pp.68~71 (1992)
- Hoops S, "Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease", Neurology, 73, pp.1738~1745 (2009)