蒙特利尔认知评估量表在帕金森病认知功能损害筛查中的应用

摘要

Objective To study the application of Montreal cognitive assessment MoCA) and mini-mental state examination(MMSE) in screening cognitive impairment in Parkinson's disease (PD) patients. Methods One hundred and twenty-nine PD patients at the age 60 years were divided into normal group,mild cognitive impairment(MCI)group and PD dementia(PDD)group according to their cognitive function. They were assessed and analyzed according to their MoCA and MMSE score. Results The MoCA score was significantly different in 3 groups(P<0. 01). The scores of "drawing cube", "retelling", "counting animals in 1 min", "similarity" and"delayed recalP'were lower in MCI and PDD groups than in normal group(P<0. 01) while the scores of "naming" ("digit span" and"orientation"were higher in normal and MCI groups than in PDD group(P<0. 05). In addition,the area under ROC for the patients was 0. 803 for the diagnosis of MCI according to MMSE,0. 803 for the diagnosis of MCI according to MMSE,0. 947 for the diagnosis of MCI according to MoCA,0. 952 for the diagnosis of PDD according to MMSE and 0. 990 for the diagnosis of PDD according to MoCA. Conclusion MoCA can be used as an effective tool for screening the cognitive impairment in PD patients. The MoCA score decreases gradually with the aggravation of PD. The MoCA optimal cutoff value is ^23 score for screening MCI in PD and the sensitivity of MoCA is higher than that of MMSE in screening PD patients.%目的 探讨蒙特利尔认知评估量表(MoCA)和简易智能状态检查量表(MMSE)在帕金森病(PD)患者认知功能损害筛查中的应用.方法 选取129例年龄≥60岁的PD患者,根据认知功能将其分为正常组(60例)、轻度认知功能障碍(MCI,37例)组和PD痴呆(PDD,32例)组,采用MoCA和MMSE对患者进行评估和分析.结果 组MoCA得分差异有统计学意义(P＜0.01).与正常组比较,MCI组和PDD组患者在画立方体、复述、1 min动物数、抽象能力、延迟回忆得分较低(P＜0.01);与PDD组比较,正常组和MCI组患者在命名、数字广度和定向力得分较高(P＜0.05).此外,受试者ROC曲线结果显示,MMSE诊断MCI的曲线下面积为0.803;MoCA诊断MC的曲线下面积为0.947.MMSE诊断PDD的曲线下面积为0.952;MoCA诊断PDD的曲线下面积为0.990.结论 MoCA可作为有效的PD患者认知功能损害的筛查工具,且随着PD患者病情的进展,MoCA得分逐渐降低MoCA筛查MCI的最佳界值为≤23分,且MoCA在筛查PD患者MCI方面的敏感性较MMSE高.