蒙特利尔认知评估量表联合延迟回忆部分限时施测应用于老年人轻度认知功能障碍筛查的研究

摘要

目的:探讨蒙特利尔认知评估量表联合延迟回忆部分限时施测应用于筛查老年轻度认知功能障碍患者的诊断价值.方法:选择我院就诊的老年患者和健康体检老年人共178例,并以欧洲阿尔茨海默病协会(EADC)的诊断标准为金标准诊断轻度认知功能障碍(mild cognitive impairment,MCI),分为正常组92例,病例组86例,采用2×2交叉试验设计,178例均接受常规方法蒙特利尔认知评估量表施测和蒙特利尔认知评估量表联合延迟回忆部分限时施测,应用受试者工作特征曲线(receiver operating characteristic curve,ROC)进行分析,取得最佳截点.结果:①常规方法蒙特利尔认知评估量表施测ROC曲线下面积为0.851,蒙特利尔认知评估量表联合延迟回忆部分限时施测曲线下面积为0.917,后者大于前者且差异有显著性意义.②常规方法蒙特利尔认知评估量表施测下的最佳截断值为25,对应敏感度为88.37％,特异度为85.37％,蒙特利尔认知评估量表联合延迟回忆部分限时施测下最佳截断值为25,对应敏感度95.35％,特异度78.26％.结论:①蒙特利尔认知评估量表联合延迟回忆部分限时施测可应用于老年轻度认知功能障碍筛查诊断,与常规方法蒙特利尔认知评估量表施测相比对老年MCI的诊断价值高.②通过ROC曲线确立的截点,可作为应用蒙特利尔认知评估量表联合延迟回忆部分限时施测评价老年轻度认知功能障碍的诊断参考.%Objective:To explore the diagnostic value of the Montreal cognitive assessment combined with delayed recall in time-limited screening for screening the elderly mild cognitive impairment (MCI) population.Method:A total of 178 elderly patients were enrolled in this study,and EADC was used to diagnose MCI.The patients were divided into normal group (n=92) and case group (n=86).178 cases were accepted by the conventional method of Montreal cognitive assessment and the Montreal cognitive assessment combined with delayed recall part of the time limit application,with the application of the receiver operating characteristic curve (ROC) for analysis,and getting the best cut-off point.Result:①The area under the ROC curve of the Montreal cognitive assessment was 0.851,the area of the Montreal cognitive assessment combined with the delayed recall in time-limited Screening was 0.917.The area under the ROC curve of the Montreal cognitive assessment combined with the delayed recall in time-limited screening was higher than that of the conventional method.The area under the ROC curve between the two ways was statistically significant,and the difference was statistically significant.②The best cut-off value of the Montreal cognitive assessment was 25,the sensitivity was 88.37％ and the specificity was 85.37％.The best cut-off value of the Montreal cognitive assessment combined with the delayed recall in time-limited screening was 25,the sensitivity was 95.35％ and the specificity was 78.26％.Conclusion:①The Montreal cognitive assessment Combined with delayed recall in time-limited screening can be applied to the diagnosis of mild cognitive impairment in the elderly.The diagnostic value of the Montreal cognitive assessment combined with the d elayed recall in time-limited screening was higher than that of the conventional method.②The cut-off point established by the ROC curve can be used as a diagnostic reference for the evaluation of mild cognitive impairment in the elderly as a part of the Montreal cognitive assessment combined with delayed recall in time-limited screening.