Xu Gelin, Meyer John S, Thornby John, Chowdhury Munir, Quach Minh
Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
Int J Geriatr Psychiatry. 2002 Nov;17(11):1027-33. doi: 10.1002/gps.744.
To test correctness of results when combining Mini-Mental State Examination (MMSE) and Cognitive Capacity Screening Examination (CCSE) for identifying mild cognitive impairment (MCI) among non-demented elderly subjects at risk for developing dementia.
A retrospective study was conducted among consecutively referred volunteers with memory complaints to a research out-patient clinic. Two cognitive screening tests (MMSE and CCSE) were performed according to established protocol. Resulting combined screening test (termed by acronym as CMC) combined the non-overlapping test items derived from both MMSE and CCSE. Conversion to dementia at follow-up served as the 'gold-standard' for evaluating correctness of CMC for identifying MCI.
Of 351 subjects completing cognitive assessments and meeting requirements for study protocol, 84 (23.9%) developed dementia of different types within 3-6 years (3.89 +/- 2.17) of follow-up. Among these, 47 met criteria for probable Alzheimer disease (AD), 22 for probable vascular dementia (VaD), 12 for mixed AD/VaD and three for probable frontotemporal dementia. When final diagnosis of AD was used as the 'gold standard' for testing correctness of MCI identified by cognitive screening tests, sensitivities of MMSE, CCSE and CMC for identifying MCI were relatively 61.0%, 74.3% and 83.1% with minimum specificity set at 80%. When diagnosis of all types of dementia was used as the standard for testing predictive correctness of MCI, CCSE emerged as an optimal MCI screening test.
Combining the CCSE and MMSE screening tests resulted in higher sensitivity than was achieved by MMSE alone and maintained specificity at comparable levels for identifying MCI. The results confirmed that CMC has optimal correctness and utility as a brief cognitive test for screening MCI as a prodrome for dementia among non-demented elderly populations.
检验将简易精神状态检查表（MMSE）和认知能力筛查检查表（CCSE）相结合，以识别有患痴呆风险的非痴呆老年受试者中的轻度认知障碍（MCI）时结果的正确性。
对连续转诊至研究门诊、有记忆问题主诉的志愿者进行回顾性研究。根据既定方案进行两项认知筛查测试（MMSE和CCSE）。由此产生的联合筛查测试（简称为CMC）将源自MMSE和CCSE的非重叠测试项目合并在一起。随访时转为痴呆作为评估CMC识别MCI正确性的“金标准”。
在351名完成认知评估并符合研究方案要求的受试者中，84名（23.9%）在随访3至6年（3.89±2.17）内发展为不同类型的痴呆。其中，47名符合可能的阿尔茨海默病（AD）标准，22名符合可能的血管性痴呆（VaD）标准，12名符合AD/VaD混合型标准，3名符合可能的额颞叶痴呆标准。当将AD的最终诊断用作检验认知筛查测试所识别MCI正确性的“金标准”时，MMSE、CCSE和CMC识别MCI的敏感性分别为61.0%、74.3%和83.1%，最低特异性设定为80%。当将所有类型痴呆的诊断用作检验MCI预测正确性的标准时，CCSE成为最佳的MCI筛查测试。
将CCSE和MMSE筛查测试相结合，比单独使用MMSE具有更高的敏感性，并且在识别MCI时保持了相当水平的特异性。结果证实，CMC作为一种简短的认知测试，在筛查MCI作为非痴呆老年人群痴呆前驱症状方面具有最佳的正确性和实用性。
