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Para Alejandra y Alvaro, Irma, Carmen y Jorge, y Julia
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A todas las personas que hicieron posible recoger la muestra: funcionarios y profesionales de las
instituciones que abrieron sus puertas y a cada uno de los adultos mayores que aceptaron ser
entrevistados y evaluados;
A los colegas y médicos que participaron en el inicial proceso de adaptación;
A la Dra. Dora Frisancho por su asesoría y estímulo, y al Ps. Miguel Escurra por su
invalorable profesionalismo, buen humor y paciencia en el procesamiento y análisis estadístico
de los datos;
A los Dres. César Sarria y Alberto Quintana, por sus valiosas sugerencias como
informantes;
A mis amigos ancianos, actuales y de otras épocas, y
A mi querido profesor Dr. Pedro Ortiz, por su obra inspiradora desde los estudios de
pregrado.
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Teniendo en consideración las tendencias poblacionales de aumento del segmento de adultos
mayores asi como la prevalencia de trastornos demenciales, se planteó como objetivo la
adaptación del Mini-Mental State Examination, instrumento ampliamente utilizado en la
atención clínica y en la investigación clínica y epidemiológica. Se aplicó el MMSE a tres
muestras: 345 sujetos sanos, 50 pacientes con diagnóstico de demencia de tipo Alzheimer y 45
pacientes con depresión mayor, todos mayores de 55 años. Se estudiaron ítems alternativos para
ser utilizados con sujetos analfabetos, que no mostraron ser adecuados estadísticamente. La
consistencia interna de la prueba fue de 0,62 con el alfa de Cronbach. Se analizó la validez de
constructo, aislándose cinco factores. En la comparación con un criterio externo de deterioro,
casos con diagnóstico de demencia, se encontró más adecuado el puntaje de corte de 23, que
arroja 86% de sensibilidad y 94% de especificidad. Los puntajes MMSE disminuyen con la edad
y son más altos con mayores niveles educativos; los analfabetos rinden significativamente
menos. Los puntajes de los grupos sano y deprimido son semejantes, diferenciándose ambos
grupos significativamente del grupo demencia. Los errores en las respuestas son más frecuentes
y variados en el grupo demencia.
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