中文版蒙特利尔认知评估量表和简易精神状态量表对老年帕金森病患者认知功能的评估

摘要

目的：研究中文版蒙特利尔认知评估量表（MoCA）和简易精神状态量表（MMSE）在判定帕金森病患者认知障碍中的作用。方法帕金森病认知功能损害患者（PD-MCI）27例，年龄教育程度匹配的对照组31例，分别进行简易精神状态量表（MMSE）、MoCA 量表检测，分析比较两量表的敏感性、特异性和各量表的子项得分。结果根据两组的教育背景，以26分为界值，MoCA、MMSE 对 PD-MCI 诊断的敏感性分别为：70．37％、14．81％；特异性分别为：83．87％和93．55％。MoCA 对 PD-MCI 的敏感性高于 MMSE。PD-MCI 组在 MMSE 测试中，仅有两个子项目（计算力及注意力、延迟回忆）得分明显低于对照组，而在 MoCA 测试中 PD-MCI 组在视空间与执行功能、延迟回忆、语言功能、抽象能力方面得分明显低于对照组。结论MMSE 不适于 PD-MCI 患者的筛查。MoCA 在对 PD 认知功能判定方面优于 MMSE，尤其是执行功能及视空间方面。%Objective To study the effect of the Chinese version of Montreal Cognitive Assessment (MoCA) and Mini -Mental State Examination (MMSE)in Parkinson's disease(PD)patients.Methods Twenty -seven PD pa-tients with mild cognitive impairment(PD-MCI)and 31 normal control subjects were evaluated by MMSE and MoCA. The sensitivity and specificity of two scales were compared and analyzed.Results According to the educational back-ground of two groups,the sensitivity of MoCA and MMSE on PD -CI were 70.37% and 14.81% respectively by 26 as the cut -off point,the specificity were 83.87% and 93.55% respectively.The sensitivity of MoCA was higher than MMSE in diagnosing PD -MCI.The scores of calculation and attention of PD-MCI group were lower than control group in MMSE test;and visuospatial,executive function,delayed recall,language function,abstract ability scores of PD-MCI were significantly lower than the control group in MoCA test.Conclusion MMSE is not suitable for screening patients with PD-MCI.MoCA is better than MMSE in the cognitive function judgment of PD,particularly for visuospatial and ex-ecutive function.