Objective: Modified Mini-Mental State Examination (3MSE) is often used to screen for dementia, but little is known about psychometric validity in American Indians. Methods: We recruited 818 American Indians aged 65–95 for 3MSE examinations in 2010–2013; 403 returned for a repeat examination in 2017–2019. Analyses included standard psychometrics inferences for interpretation, generalizability, and extrapolation: factor analysis; internal consistency-reliability; test-retest score stability; multiple indicator multiple cause structural equation models. Results: This cohort was mean age 73, majority female, mean 12 years education, and majority bilingual. The 4-factor and 2nd-order models fit best, with subfactors for orientation and visuo-construction (OVC), language and executive functioning (LEF), psychomotor and working memory (PMWM), verbal and episodic memory (VEM). Factor structure was supported for both research and clinical interpretation, and factor loadings were moderate to high. Scores were generally consistent over mean 7 years. Younger participants performed better in overall scores, but not in individual factors. Males performed better on OVC and LEF, females better on PMWM. Those with more education performed better on LEF and worse on OVC; the converse was true for bilinguals. All differences were significant, but small. Conclusion: These findings support use of 3MSE for individual interpretation in clinic and research among American Indians, with moderate consistency, stability, reliability over time. Observed extrapolations across age, sex, education, and bilingual groups suggest some important contextual differences may exist.

中文翻译：

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美洲印第安人成年人 3MSE 分数的心理测量可靠性、有效性和普遍性：强心脏研究

目的：改良简易精神状态检查 (3MSE) 通常用于筛查痴呆症，但对于美洲印第安人心理测量的有效性知之甚少。方法：我们在 2010-2013 年招募了 818 名 65-95 岁的美国印第安人进行 3MSE 考试；2017-2019 年有 403 人返回复查。分析包括用于解释、概括性和外推的标准心理测量学推论：因素分析；内部一致性-可靠性；重测分数稳定性；多指标多因结构方程模型。结果：该队列的平均年龄为 73 岁，大多数为女性，平均受教育年限为 12 年，大多数人会说双语。四因素和二阶模型最适合，子因素包括方向和视觉建构（OVC）、语言和执行功能（LEF）、精神运动和工作记忆（PMWM）、言语和情景记忆（VEM）。研究和临床解释均支持因子结构，因子负荷为中等到高。平均 7 年的分数基本保持一致。年轻的参与者在总体得分上表现更好，但在个人因素上表现不佳。男性在 OVC 和 LEF 上表现更好，女性在 PMWM 上表现更好。受教育程度较高的人在 LEF 上表现较好，在 OVC 上表现较差；对于双语者来说，情况正好相反。所有差异都很显着，但很小。结论：这些研究结果支持在美洲印第安人的临床和研究中使用 3MSE 进行个体解释，随着时间的推移具有中等的一致性、稳定性和可靠性。对年龄、性别、教育程度和双语群体的观察推断表明，可能存在一些重要的背景差异。