出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2013/07/17 09:44:44」(JST)
The mini–mental state examination (MMSE) or Folstein test is a brief 30-point questionnaire test that is used to screen for cognitive impairment. It is commonly used in medicine to screen for dementia. It is also used to estimate the severity of cognitive impairment and to follow the course of cognitive changes in an individual over time, thus making it an effective way to document an individual's response to treatment.
In about 10 minutes it samples functions including arithmetic, memory and orientation. It was introduced by Folstein et al. in 1975,[1] but is very similar to, or even directly incorporates, tests which were in use previous to its publication.[2][3][4] This test is not a mental status examination. The standard MMSE form which is currently published by Psychological Assessment Resources is based on its original 1975 conceptualization, with minor subsequent modifications by the authors.
Other tests are also used, such as the Hodkinson[5] abbreviated mental test score (1972, geriatrics) or the General Practitioner Assessment Of Cognition as well as longer formal tests for deeper analysis of specific deficits.
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The MMSE test includes simple questions and problems in a number of areas: the time and place of the test, repeating lists of words, arithmetic such as the serial sevens, language use and comprehension, and basic motor skills. For example, one question, derived from the older Bender-Gestalt Test, asks to copy a drawing of two pentagons (shown on the right).[1]
Although consistent application of identical questions increases the reliability of comparisons made using the scale, the test is sometimes customized (for example, for use on patients that are intubated, blind, or partially immobilized. Also, some have questioned the use of the test on the deaf.[6] However, the number of points assigned per category is usually consistent:
Category | Possible points | Description |
---|---|---|
Orientation to time | 5 | From broadest to most narrow. Orientation to time has been correlated with future decline.[7] |
Orientation to place | 5 | From broadest to most narrow. This is sometimes narrowed down to streets,[8] and sometimes to floor.[9] |
Registration | 3 | Repeating named prompts |
Attention and calculation | 5 | Serial sevens, or spelling "world" backwards[10] It has been suggested that serial sevens may be more appropriate in a population where English is not the first language.[11] |
Recall | 3 | Registration recall |
Language | 2 | Naming a pencil and a watch |
Repetition | 1 | Speaking back a phrase |
Complex commands | 6 | Varies. Can involve drawing figure shown. |
Any score greater than or equal to 25 points (out of 30) indicates a normal cognition. Below this, scores can indicate severe (≤9 points), moderate (10-20 points) or mild (21-24 points) cognitive impairment.[12] The raw score may also need to be corrected for educational attainment and age.[13] That is, a maximal score of 30 points can never rule out dementia. Low to very low scores correlate closely with the presence of dementia, although other mental disorders can also lead to abnormal findings on MMSE testing. The presence of purely physical problems can also interfere with interpretation if not properly noted; for example, a patient may be physically unable to hear or read instructions properly, or may have a motor deficit that affects writing and drawing skills.
The MMSE has been able to differentiate different types of dementias. Studies have found that patients with Alzheimer's disease score significantly lower on orientation to time and place, and recall compared to patients with dementia with Lewy bodies, vascular dementia and Parkinson's disease dementia.[14][15][16]
The MMSE was first published in 1975 as an appendix to an article written by Marshal F. Folstein, Susan Folstein, and Paul R. McHugh.[1] It was published in Volume 12 of the Journal of Psychiatric Research, published by Pergamon Press. While the MMSE was attached as an appendix to the article, the copyright ownership of the MMSE (to the extent that it contains copyrightable content[17]) remained with the three authors. Pergamon Press was subsequently taken over by Elsevier, who also took over copyright of the Journal of Psychiatric Research.[18]
The authors later transferred all their intellectual property rights, including the copyright of the MMSE, to MiniMental registering the transfer with the U.S. Copyright Office on June 8, 2000.[19] In March 2001, MiniMental entered into an exclusive agreement with Psychological Assessment Resources granting PAR the exclusive rights to publish, license, and manage all intellectual property rights to the MMSE in all media and languages in the world.[20] Despite the many free versions of the test that are available on the internet, PAR claims that the official version is copyrighted and must be ordered only through it.[21][22] At least one legal expert has claimed that PAR's copyright claims are weak.[17] The enforcement of copyright on the MMSE has been compared to the phenomenon of "stealth" or "submarine" patents, in which a patent applicant waited until an invention gained widespread popularity before allowing the patent to issue, and only then commenced enforcement. Such applications are no longer possible, given changes in patent law.[21] The enforcement of the copyright has led to researchers looking for alternative strategies in assessing cognition.[23]
PAR have also asserted their copyright against an alternative diagnostic test, "Sweet 16," which was designed to avoid the copyright issues surrounding the MMSE. Sweet 16 was a 16-item assessment developed and validated by Tamara Fong and published in March 2011; like the MMSE it included orientation and three-object recall. Assertion of copyright forced the removal of this test from the Internet.[24]
In February 2010, PAR released a second edition of the MMSE; 10 foreign language translations (French, German, Dutch, Spanish for the US, Spanish for Latin America, European Spanish, Hindi, Russian, Italian, and Simplified Chinese) were also created.[25]
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国試過去問 | 「110B053」「110B054」「110B055」「114F061」「113A058」「099I005」「113D032」「109E051」「112A058」「105G041」「104A058」「107E057」「105E055」「109C016」「102A024」「101B089」「105B011」「110B001」「107B025」「111G009」 |
リンク元 | 「認知症」「ミニ・メンタル・ステート・テスト」「MMSE」 |
関連記事 | 「examination」「state」「mental」「mini-mental state examination」 |
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※国試ナビ4※ [107E056]←[国試_107]→[107E058]
C
※国試ナビ4※ [105E054]←[国試_105]→[105E056]
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※国試ナビ4※ [109C015]←[国試_109]→[109C017]
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など
アルツハイマー病 | 脳血管性認知症 | ピック病 | |
認知症 | 全般的認知症 | まだら認知症 | アルツハイマー病に類似。 早期には人格、注意力が障害され、 次第に記憶力も障害される。 |
人格 | 晩期に人格障害 | 保たれる | 早期に人格障害 |
病識 | なし(初期にはあり) | あり | なし |
経過 | 進行性 | 動揺性、階段状に進行性 | 進行性 |
基礎疾患 | 特になし | 高血圧、糖尿病、心疾患 | 特になし |
画像検査 | 対称性の脳溝開大 | 脳実質内に脳梗塞巣 | 側頭葉と前頭葉の萎縮 |
機能画像検査 | 側頭葉、頭頂葉での代謝低下 | 前頭葉を中心とした多発性の脳代謝低下 | 前頭葉、側頭葉での代謝低下 |
相談体制 | 保健所 | 地域保健法が定める事業内容「母性及び乳幼児並びに老人の保健に関する事項」による老人精神衛生相談事業 | |
高齢者総合相談センター | 厚労省が都道府県レベルに設置している高齢者に関する相談窓口 | ||
在宅介護支援センター | 老人福祉法により市町村が実施の主体となっている施設であり、在宅の要介護高齢者やその介護者の要望に対応した適切なサービスが円滑に提供されるように市町村や関連機関との連絡・調節などを行っている。 | ||
認知症疾患医療センター | |||
在宅対策 | 介護 | 訪問介護 | ホームヘルプサービス |
通所介護 | デイサービス | ||
短期入所生活介護 | ショートステイ | ||
認知症老人向け毎日通所型デイサービスセンター | |||
認知症対応型老人共同生活介護 | グループホーム | ||
老人認知症疾患デイ・ケア施設 | |||
福祉 | 訪問指導 | ||
施設対策 | 介護 | 介護療養型医療施設 | |
介護老人保健施設 | |||
介護老人福祉施設 | |||
医療 | 老人性認知症疾患治療病棟 | ||
福祉 | 養護老人ホーム | ||
特別養護老人ホーム |
簡易知能試験 : 13 件 ミニ・メンタル・ステート・テスト : 24 件
[★] ミニ・メンタル・ステート・テスト Mini-Mental State Examination
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