ANÁLISIS RASCH DEL MINI MENTAL STATE EXAMINATION (MMSE) EN ADULTOS MAYORES DE ANTIOQUIA, COLOMBIA (Rasch analysis of the Mini Mental State Examination (MMSE) in older adults in Antioquia, Colombia)

Diego Fernando Rojas-Gualdron, Alejandra Segura Cardona, Doris Cardona Arango, Ángela Segura Cardona, María Osley Garzón Duque

Resumen


Objetivo. Evaluar las evidencias de validez del Mini Mental State Examination que sustentan su interpretación en adultos mayores. Métodos. Estudio de fuente secundaria con la participación de 4034 adultos mayores residentes de Antioquia, Colombia, 2012. Se siguieron los lineamientos de Wolfe y Smith para análisis desde el modelo Rasch. Resultados. Se identificó dependencia local entre los ítems de atención y cálculo. Estos producen una segunda medida que afecta la unidimensionalidad del instrumento. La confiabilidad de los ítems fue de 0,80, la medida explicó el 45,2% de la varianza de las puntuaciones crudas. Conclusión. Los resultados sugieren diferenciar las habilidades de atención y cálculo de los demás procesos cognitivos considerados por el instrumento. El MMSE presenta limitaciones de validez de generalización que potencialmente afectan comparaciones transculturales.

 

Palabras claves: Salud mental, Cognición, Anciano, Estudios de Validación

 

Abstract

Objective. To evaluate validity of the Mini-Mental State Examination (MMSE) that supports the interpretability in older adults. Methods.  Secondary data study administered in 4.034 older adults in Antioquia, Colombia, 2012. Data were analyzed from Rasch models according to Wolfe and Smith guidelines. Results. Attention and calculation items showed local dependency. They produce a second relevant measure affecting the unidimensional type of the test. The reliability of the items was of 0.80, the measure explained 45.2% of the raw score variance. Conclusion. Results suggest differentiating attention and calculation abilities from the other cognitive processes considered by the test. MMSE shows generalization validity limitations that may affect transcultural comparisons.

Keywords. Mental Health, Cognition, Aged, Validation Studies

DOI: http://dx.doi.org/10.21615/cesp.10.2.2


Palabras clave


Salud mental; Cognición, Anciano; Estudios de validación

Citas


Babacan-Yıldız, G., Ur-Özçelik, E., Kolukısa, M., Işık, A. T., Gürsoy, E., Kocaman, G., & Çelebi, A. (2016). [Validity and Reliability Studies of Modified Mini Mental State Examination (MMSE-E) For Turkish Illiterate Patients With Diagnosis of Alzheimer Disease]. Türk Psikiyatri Dergisi = Turkish Journal of Psychiatry, 27(1), 41-46.

Bell R, & Hall RC. (1977). The mental status examination. American Family Physician, 16(5), 635-641. Recuperado a partir de http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=920569&site=eds-live

Bermejo Pareja, F., Díaz Guzmán, J., & Porta-Etessam, J. (2001). Cien escalas de interés en neurología clínica. Barcelona.: Prous Science.

Bland, J. M., & Altman, D. G. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 1(8476), 307-310.

Bond, T. (2004). Validity and assessment: a Rasch measurement perspective. Metodología de las Ciencias del Comportamiento, 5, 179–194.

Bond, T. G., & Fox, C. M. (2001). Applying the Rasch Model: Fundamental Measurement in the Human Sciences. Erlbaum.

Arango, D. C., Cardona, A. S., Duque, M. G., Cardona, A. S., & Sierra, S. M. C. (2016). Health status of elderly persons of Antioquia, Colombia. Revista Brasileira de Geriatria E Gerontologia, 19(1), 71-86. https://doi.org/10.1590/1809-9823.2016.14199

Carnero-Pardo, C. (2014). ¿Es hora de jubilar al Mini-Mental? Neurología, 29(8), 473-481. http://doi.org/10.1016/j.nrl.2013.07.003

Cortés-Muñoz, C., Cardona-Arango, D., Segura-Cardona, Á., & Garzón-Duque, M. O. (2016). Demographic, social, physical and mental factors associated with functional capacity in the elderly, Antioquia, Colombia, 2012. Revista de Salud Pública, 18(2), 167-178. http://doi.org/10.15446/rsap.v18n2.49237

Creavin, S. T., Cullum, S. J., Haworth, J., Wye, L., Bayer, A., Fish, M., … Ben-Shlomo, Y. (2016). Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol. BMC Family Practice, 17(1), 79. http://doi.org/10.1186/s12875-016-0475-2

Engelhard, G. (2013). Invariant measurement: using Rasch models in the social, behavioral, and health sciences. New York: Routledge.

Fischer, G. H., & Molenaar, I. W. (1995). Rasch Models: Foundations, Recent Developments, and Applications. Springer.

Fliss, R., Lemerre, M., & Mollard, A. (2016). Performances on a cognitive theory of mind task: specific decline or general cognitive deficits? Evidence from normal aging. Geriatrie Et Psychologie Neuropsychiatrie Du Vieillissement, 14(2), 221-230. http://doi.org/10.1684/pnv.2016.0603

Folstein, MF., Folstein, SE., & McHugh, PR. (1975). «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. Journal Of Psychiatric Research, 12(3). Recuperado a partir de http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=1202204&site=eds-live

Jones, R. N. (2006). Identification of measurement differences between English and Spanish language versions of the Mini-Mental State Examination. Detecting differential item functioning using MIMIC modeling. Medical Care, 44(11 Suppl 3), S124-133. http://doi.org/10.1097/01.mlr.0000245250.50114.0f

Kane, M. T. (2001). Current Concerns in Validity Theory. Journal of Educational Measurement, 38(4), 319-342.

Kopecek, M., Bezdicek, O., Sulc, Z., Lukavsky, J., & Stepankova, H. (2016). Montreal Cognitive Assessment and Mini-Mental State Examination reliable change indices in healthy older adults. International Journal of Geriatric Psychiatry. http://doi.org/10.1002/gps.4539

Linacre, J. M. (2016). Winsteps® Rasch measurement computer program. (Versión 3.92.1). Beaverton, Oregon. Recuperado a partir de www.winsteps.com

Llamas-Velasco, S., Llorente-Ayuso, L., Contador, I., & Bermejo-Pareja, F. (2015). [Spanish versions of the Minimental State Examination (MMSE). Questions for their use in clinical practice]. Revista De Neurologia, 61(8). Recuperado a partir de http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=26461130&site=eds-live

Messick, S. (1995). Validity of psychological assessment: Validation of inferences from persons’ responses and performances as scientific inquiry into score meaning. American Psychologist, 50(9), 741-749. http://doi.org/10.1037/0003-066X.50.9.741

Olazarán Rodríguez, J., & Bermejo Pareja, F. (2015). No hay razones científicas para jubilar al MMSE. Neurología, 30(9), 589-591. http://doi.org/10.1016/j.nrl.2014.03.011

Pedraza, O., Sánchez, E., Plata, S. J., Montalvo, C., Galvis, P., Chiquillo, A., & Arévalo-Rodríguez, I. (2014). Puntuaciones del MoCA y el MMSE en pacientes con deterioro cognitivo leve y demencia en una clínica de memoria en Bogotá. Acta Neurológica Colombiana, 30(1), 22-31.

Prieto, G., Delgado, A. R., Perea, M. V., & Ladera, V. (2011). Funcionamiento diferencial de los ítems del test Mini-mental en función de la patología. Neurología, 26(8), 474-480. http://doi.org/10.1016/j.nrl.2011.01.013

Requena, C., Turrero, A., & Ortiz, T. (2016). Six-Year Training Improves Everyday Memory in Healthy Older People. Randomized Controlled Trial. Frontiers in Aging Neuroscience, 8, 135. http://doi.org/10.3389/fnagi.2016.00135

Rosselli, D., Ardila, A., Pradilla, G., Morillo, L., Bautista, L., Rey, O., & Camacho, M. (2000). [The Mini-Mental State Examination as a selected diagnostic test for dementia: a Colombian population study. GENECO]. Revista De Neurologia, 30(5), 428-432.

StataCorp. (2011). Stata Statistical Software (Versión 14). College Station, TX: StataCorp LP.

Stelmack, J., Szlyk, J. P., Stelmack, T., Babcock-Parziale, J., Demers-Turco, P., Williams, R. T., & Massof, R. W. (2004). Use of Rasch person-item map in exploratory data analysis: A clinical perspective. Journal of Rehabilitation Research & Development, 41(2), 233-241.

Tennant, A., Penta, M., Tesio, L., Grimby, G., Thonnard, J.-L., Slade, A., … Phillips, S. (2004). Assessing and adjusting for cross-cultural validity of impairment and activity limitation scales through differential item functioning within the framework of the Rasch model: the PRO-ESOR project. Medical Care, 42(1 Suppl), I37-48. http://doi.org/10.1097/01.mlr.0000103529.63132.77

Thissen, D., Steinberg, L., & Kuang, D. (2002). Quick and Easy Implementation of the Benjamini-Hochberg Procedure for Controlling the False Positive Rate in Multiple Comparisons. Journal of Educational and Behavioral Statistics, 27(1), 77-83. http://doi.org/10.3102/10769986027001077

Wolfe, E. W., & Smith, E. V., Jr. (2007). Instrument development tools and activities for measure validation using Rasch models: part II--validation activities. Journal of Applied Measurement, 8(2), 204-234.


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Revista CES Psicología/ISSN 2011-3080 Facultad de Psicología Universidad CES

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