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Arquivos de Neuro-Psiquiatria

versão impressa ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.52 no.1 São Paulo mar. 1994

http://dx.doi.org/10.1590/S0004-282X1994000100001 

O Mini-Exame do Estado Mental em uma população geral: impacto da escolaridade

 

The Mini-Mental State Examination in an outpatient population: influence of literacy

 

 

Paulo H.F. BertolucciI; Sonia M.D. BruckiI; Sandra R. CampacciI; Yara JulianoII

IDisciplina de Neurologia do Departamento de Neurologia e Neurocirurgia
IIDisciplina de Bioestatística do Departamento de Medicina Preventiva da Escola Paulista de Medicina

 

 


RESUMO

O Mini-Exame do Estado Mental (MEM) foi aplicado em 530 indivíduos, classificados segundo suas idades e escolaridades, para avaliarmos o desempenho dessa população de nosso meio. Constatou-se que, para essa amostra, a idade não interferiu nos escores alcançados. Entretanto, ao comparar quatro níveis de escolaridade (analfabetos, baixa, média e alta) obtivemos diferença estatística significante (p<0,0001) entre os escores, exceto para os indivíduos de baixa e média escolaridade quando comparados entre si. Foram estipulados valores de corte para cada grupo, tomando-se como referência o percentil 5% da porção inferior da curva de distribuição dos valores dos escores. Estes foram: 13 para analfabetos, 18 para baixa e média e 26 para alta escolaridade. Comparando-se estes resultados aos obtidos com o MEM em 94 indivíduos com déficits cognitivos comprovados, utilizando os níveis de corte por nós determinados encontramos: sensibilidade de 82,4% para analfabetos, 75,6% para baixa e média e 80% para alta escolaridade; e especificidade de 97,5% para analfabetos, 96,6% para baixa e média e 95,6% para alta escolaridade. Acreditamos que devam ser utilizados níveis de corte diferenciados para cada escolaridade a fim de que erros diagnósticos possam ser minimizados.

Palavras-chave: cognição, estado educacional, testes neuropsicológicos, Mini-Exame do Estado Mental.


SUMMARY

To assess the influence of age and education on cognitive performance in our population, 530 adults were interviewed using the MMSE (Mini-Mental Status Examination). Education level, classified as illiterate, elementary and middle (< 8 years) and high (> 8 years), was a significant predictor of performance (p < 0.0001). Nevertheless, the total scores were not significantly different among the age-groups, young (< or = 50 years), middle age 51 to 64 years) and elderly (> or = 65 years). The reference cut-off values were taken from the fifth percent lowest score for each group: illiterate, 13; elementary and middle, 18; and high, 26. When compared to 94 pacients with cognitive impairment, our cut-off values achieved high sensitivity (82.4% for illiterates; 75.6% for elementary and middle; 80% for high) and specificity (97.5% for illiterate; 96.6% for elementary and middle; 95.6% for high educational level). Education-specific reference values for the MMSE are necessary in interpreting individual test results in populations of low educational level, in order to reduce the false positive results.

Key words: cognition, educational status, neuropsychological tests, Mini-Mental State Examination.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

Agradecimentos - Agradecemos a Suzana M.F. Malheiros, Ana Cláudia Picollo, Adriana A Fujinami, Henrique B. Ferraz e João S. Pereira pela ajuda na aplicação do teste; a Afonso C. Neves por permitir o uso dos escores de pacientes confusos; a Neil F. Novo pelo auxílio na análise estatística.

 

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Aceite: 3-agosto-1993.

 

 

Dr. Paulo H.F. Bertolucci - Disciplina de Neurologia, Escola Paulista de Medicina - Rua Botucatu 762 - 04023-900 São Paulo SP - Brasil.

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