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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 mdicos que participaron en el inicial proceso de adaptacin;
A la Dra. Dora Frisancho por su asesora y estmulo, y al Ps. Miguel Escurra por su
invalorable profesionalismo, buen humor y paciencia en el procesamiento y anlisis estadstico
de los datos;
A los Dres. Csar Sarria y Alberto Quintana, por sus valiosas sugerencias como
informantes;
A mis amigos ancianos, actuales y de otras pocas, y
A mi querido profesor Dr. Pedro Ortiz, por su obra inspiradora desde los estudios de
pregrado.
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Teniendo en consideracin las tendencias poblacionales de aumento del segmento de adultos
mayores asi como la prevalencia de trastornos demenciales, se plante como objetivo la
adaptacin del Mini-Mental State Examination, instrumento ampliamente utilizado en la
atencin clnica y en la investigacin clnica y epidemiolgica. Se aplic el MMSE a tres
muestras: 345 sujetos sanos, 50 pacientes con diagnstico de demencia de tipo Alzheimer y 45
pacientes con depresin mayor, todos mayores de 55 aos. Se estudiaron tems alternativos para
ser utilizados con sujetos analfabetos, que no mostraron ser adecuados estadsticamente. La
consistencia interna de la prueba fue de 0,62 con el alfa de Cronbach. Se analiz la validez de
constructo, aislndose cinco factores. En la comparacin con un criterio externo de deterioro,
casos con diagnstico de demencia, se encontr ms 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 ms altos con mayores niveles educativos; los analfabetos rinden significativamente
menos. Los puntajes de los grupos sano y deprimido son semejantes, diferencindose ambos
grupos significativamente del grupo demencia. Los errores en las respuestas son ms frecuentes
y variados en el grupo demencia.
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