Objective:To evaluate the efficacy of modified mini-mental state examination(MMSE) in elderly patients with severe to profound hearing loss. Methods:A total of 24 elderly patients with severe to profound hearing loss from April to June 2019 were involved. Severe to profound hearing loss was defined by a pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz in the better-hearing ear. Modified and original MMSE was completed for the patients at first visit. Two weeks later, they all return hospital and MMSE were carried out by the other method. The aggregate score and subitem score of MMSE by modified and original instrument were analyzed. The degree of cognitive impairment evaluated by two methods were compared. Results:Among the 24 patients, the mean MMSE score by routine method and improved method were 10.88±9.70 and 25.29±3.70(P<0.01). The average score of sub-items of MMSE with routine method and improved method are as follows: orientation 3.21±4.03 vs 8.71±1.92(P<0.01), registration 1.04±1.33 vs 2.79±0.51(P<0.01), attention and calculation 1.63±2.02 vs 4.00±1.41(P<0.01), recall 0.79±1.14 vs 2.50±0.72(P<0.01), language 4.21±2.11 vs 7.29±1.33(P<0.01). Compared with the routine method, the degree of cognitive impairment getting better in 83.3% patients with improved method, meanwhile, 16.7% of the patients remain the same and no deterioration. Conclusion:The routine method of MMSE should be improved to seek the real cognitive state of the patients with severe to profound hearing loss.
目的:针对重度-极重度感音神经性听力损失患者口语交流困难设计改良版简易精神状态评估量表(MMSE),并比较改良方法和常规方法所测得的患者认知功能状态差异。 方法:2019年4—6月因听力损失就诊的重度-极重度感音神经性听力损失患者共24例作为研究对象,分别采用常规评估方法和改良评估方法进行MMSE评估,比较两种指导方式下MMSE总分及各认知域亚项得分差异,比较相应分值下认知功能障碍程度的差异。 结果:24例患者中,常规评估方法和改良方法下MMSE平均得分分别为10.88±9.70和25.29±3.70(P<0.01)。常规评估方法和改良评估方法下MMSE不同认知域亚项的平均得分:定向力分别为3.21±4.03和8.71±1.92、记忆力分别为1.04±1.33和2.79±0.51、注意力和计算力分别为1.63±2.02和4.00±1.41、回忆能力分别为0.79±1.14和2.50±0.72、语言能力分别为4.21±2.11和7.29±1.33。常规评估方法和改良评估方法下不同认知功能障碍程度的例数:正常认知功能分别为1例和11例,轻度认知功能障碍分别为5例和11例,中度认知功能障碍分别为4例和2例,重度认知功能障碍分别为14例和0例。改良评估方法与常规评估方法相比,83.3%的患者的认知功能障碍程度得到改善,16.7%的患者保持不变。 结论:在评估重度-极重度聋患者的认知功能水平时,使用改良版MMSE测得患者的认知功能状态更为准确。.
Keywords: cognitive function; mini-mental state examination; presbycusis; severe to profound hearing loss.
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