ABSTRACT

Objective: To evaluate the factor structure of the Modified Mini Mental State (3MS) Exam and its suitability as a cognitive screening tool among individuals admitted to an inpatient rehabilitation unit for new-onset neurological injury/illness.

Method: A retrospective chart review was conducted. Of the 187 individuals meeting the inclusion criteria, 116 had a diffuse pattern of neurological injury/illness; 71 had a focal injury/illness. Confirmatory and exploratory factor analyses (CFA; EFA) were conducted for the whole sample and separately by group.

Results: The CFA suggested poor fit indices. The EFA of the total sample suggested a three-factor solution (Orientation/Awareness; Learning/Recall and Executive Functioning; Psychomotor Ability). The EFA of the diffuse subsample suggested a three-factor solution (Attention and Learning/Recall; Psychomotor Ability; Expressive Language). The Orientation/Awareness, Learning/Recall, Executive Functioning, Psychomotor Ability, and Expressive Language four-factor solution observed among the focal subsample was considered invalid.

Conclusion: The 3MS provides information about the pattern of cognitive performance among individuals in neurorehabilitation; clinicians are advised to interpret total scores with caution. Among individuals with focal injuries/illnesses, clinicians might use the 3MS to compare the pattern of cognitive ability to expectations for performance and to support strengths-based approaches to participation in rehabilitation therapies.

摘要

目的：评估改良的简易精神状态 (3MS) 考试的因素结构及其作为新发神经损伤/疾病住院康复病房个体认知筛查工具的适用性。

方法：进行了回顾性图表审查。在符合纳入标准的 187 人中，116 人具有弥漫性神经损伤/疾病模式；71 人有局灶性损伤/疾病。对整个样本并按组分别进行了验证性和探索性因素分析（CFA；EFA）。

结果：CFA 建议拟合指数较差。总样本的 EFA 建议采用三因素解决方案（定向/意识；学习/回忆和执行功能；心理运动能力）。扩散子样本的 EFA 提出了一个三因素解决方案（注意力和学习/回忆；心理运动能力；表达语言）。在焦点子样本中观察到的定向/意识、学习/回忆、执行功能、心理运动能力和表达语言四因素解决方案被认为是无效的。

结论：3MS 提供了关于神经康复个体认知表现模式的信息；建议临床医生谨慎解读总分。在有局灶性损伤/疾病的个体中，临床医生可能会使用 3MS 来比较认知能力模式与对表现的期望，并支持基于优势的参与康复治疗的方法。