Application study of quick cognitive screening test in identifying mild cognitive impairment
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To assess whether quick cognitive screening test (QCST) could quickly identify mild cognitive impairment (MCI).
QCST and a full set of standardized neuropsychological tests, including mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) were performed. A total number of 121 cases of MCI [41 cases of amnestic MCI-single domain (aMCI-s); 44 of amnestic MCI-multiple domain (aMCI-m); 36 of nonamnestic MCI (naMCI)], 79 cases of mild Alzheimer’s disease (AD) and 186 healthy elderly volunteers were employed in the present study. All the participants (55–85 years old) had an educational level no less than 5 years. QCST subtests included word list recall, naming test, animal fluency test, similarity test, color trail-1min, clock drawing test, finger construction test, and digit span test. The total score of QCST was 90 points, 10 points for each index of subtests.
The total scores of QCST in MCI, AD and the control groups were (58.13±8.18), (44.53±10.54) and (72.92±6.85) points, respectively. According to the educational level, the cut off scores of participants with an educational level of 5–8 years, 9–12 years and more than 13 years were 63, 65 and 68 points, respectively. The sensitivity and specificity of QCST in detection of MCI were 87.6% (85.7% for aMCI-s, 90.1% for aMCI-m and 89.5% for naMCI) and 84.3%, respectively. The area under the curve was 0.923 (95% CI: 0.892–0.953). Delayed memory, color trail-1min and similarity test could help distinguish between aMCI and naMCI.
QCST may have a good sensitivity and specificity for MCI detection, which warrants its further clinical application.
Keywordsmild cognitive impairment Alzheimer’s disease neuropsychological test cognition
轻度认知损害(mild cognitive impairment, MCI)可根据认知表现分为遗忘型 MCI (aMCI)和非遗忘型MCI(naMCI)。 本研究旨在编制快速认知筛查测验(quick cognitive screening test, QCST)便于快速全面地识别MCI, 为进一步研究提供依据。
符合 MCI 操作性诊断标准的MCI 组121 例、 符合DSM-IV有关痴呆诊断标准的阿尔茨海默病(AD)组79 例和正常老年人组186 例, 参与了QCST 和标准化全套神经心理测验。 参与者教育程度均在5 年或以上, 年龄55–85 岁。 QCST 项目包括即刻记忆、 延迟回忆、 命名、 动物流畅性、 相似性、 彩色连线B、 画钟、 手指结构、 数字广度等9 个分测验, 每个分测验满分10 分, 总分90 分, 耗时10–15 分钟。
MCI 组、 AD组和正常老年人组QCST总分分别为(58.13±8.18)、 (44.53±10.54)和(72.92±6.85)分。 制定教育程度在5–8年、 9–12 年、 高于13 年3 个组别的QCST 总分的划界分分别为63、 65 和68 分。 QCST 识别 MCI 的敏感性为87.6%, 其中识别aMCI-s、 aMCI-m 和naMCI 的敏感性分别为85.7%、 90.1% 和89.5%, 特异性均为84.3%。 曲线下面积为0.923 (95% CI: 0.892–0.953)。 延迟回忆、 连线和相似性均有助于区分aMCI 与naMCI。
QCST 对MCI 具有较高的敏感性和特异性, 可在临床和流行病学调查方面进行推广应用。
关键词轻度认知损害 阿尔茨海默病 神经心理测验 认知
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