Artículo de revista
Evaluación del minimental abreviado de la evaluación funcional del adulto mayor (EFAM) como screening para la detección de demencia en la atención primaria
Fecha
2017Registro en:
Rev Med Chile 2017; 145: 862-868
0717-6163
Autor
Jiménez Fernández, Daniel
Lavados Germain, Pablo Manuel
Rojas, Paula
Henríquez, Claudio
Silva, Fernando
Guillón, Marta
Institución
Resumen
Background: The usefulness of the abbreviated Mini-Mental State Examination
included in the Chilean Functional assessment of elderly people (MMSE-
EFAM) to detect Dementia has not been determined. Aim: To assess the performance
of the MMSE-EFAM to detect dementia. Material and Methods: We
studied a non-probabilistic sample of subjects older than 65 years who had been
assessed by the MMSE-EFAM in a Chilean primary care center during a period
of 6 months. Patients underwent clinical evaluation by a neurologist blinded to
MMSE-EFAM score, to establish the diagnosis of dementia using DSM-IV-TR
criteria. Besides, the full Mini-Mental State Examination (MMSE) was applied.
Results: The clinical diagnosis of Dementia was established in 13 of the 54 peoples
evaluated. MMSE-EFAM had a sensitivity of 30.8% (95% confidence intervals
(CI); 9-61.4) and a specificity of 90.2% (95% CI; 76.9%-97.3%), while MMSE
had a sensitivity of 84.6% (95% CI; 54.6-98.1) and a specificity of 58.5% (95%
CI; 42.1-73.7). In a receiver operating characteristic (ROC) curve analysis, the
areas under the curve (AUC) were 0.77 (95% CI; 0.61-0.93) and 0.82 (95%
CI; 0.70-0.95) for MMSE-EFAM and MMSE, respectively. Socio-demographic
variables did not influence test performance in both cases. Conclusions: MMSE-
EFAM has a low sensitivity to detect patients with Dementia and it is not
an effective screening tool. These results are in agreement with the evidence and
international guidelines that do not support the use of cognitive screening tools
to detect dementia in the older general population.