Knafelc Richard, Lo Giudice Dina, Harrigan Susan, Cook Roslyn, Flicker Leon, Mackinnon Andrew, Ames David
Bundoora Extended Care Centre, Bundoora, Victoria, Australia.
Age Ageing. 2003 Sep;32(5):541-7. doi: 10.1093/ageing/afg088.
A cognitive test and an informant report questionnaire were used together to investigate whether their combined use could improve the accuracy of detecting dementia in a memory clinic, compared with either test used alone.
The subjects were 323 patients assessed at a memory clinic. The Mini-Mental State Examination and the short form of the Informant Questionnaire on Cognitive Decline in the Elderly were used. A method of combining the test scores developed by Mackinnon and Mulligan [Am J Psychiatry 1998; 155: 1529-35] was used. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised criteria.
Logistic regression analysis showed that the combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly produced a slightly more accurate prediction of dementia caseness than either test used alone. Using receiver operating characteristic analysis the performance of the combination of the tests according to a weighted sum rule was compared with the performance of either test used alone. This way of combining the tests resulted in a more accurate screening for dementia than when the Informant Questionnaire on Cognitive Decline in the Elderly was used alone. The area under the receiver operating characteristic curve for the Mini-Mental State Examination combined with the Informant Questionnaire on Cognitive Decline in the Elderly was 0.89 compared with 0.82 for the Informant Questionnaire on Cognitive Decline in the Elderly alone (chi-square = 10.63; P = 0.0011). However, there was no improvement in screening performance when the combination of Mini-Mental State Examination and Informant Questionnaire on Cognitive Decline in the Elderly was compared with the Mini-Mental State Examination used alone (area under the receiver operating characteristic curve = 0.89 versus 0.86; chi-square = 3.54; P = 0.060).
The combination of cognitive testing and an informant report according to a weighted sum rule in this population did not result in any advantage over the use of the Mini-Mental State Examination alone. The mixed results of this study contrast with those of Mackinnon and Mulligan.
同时使用认知测试和知情者报告问卷，以研究与单独使用任一测试相比，二者联合使用是否能提高记忆门诊中痴呆检测的准确性。
研究对象为在记忆门诊接受评估的323名患者。使用简易精神状态检查表和老年认知功能减退知情者问卷简表。采用了麦金农和马利根[《美国精神病学杂志》1998年；155:1529 - 35]开发的一种综合测试分数的方法。根据《精神疾病诊断与统计手册》第三版修订标准诊断痴呆。
逻辑回归分析表明，简易精神状态检查表和老年认知功能减退知情者问卷联合使用对痴呆病例的预测准确性略高于单独使用任一测试。使用受试者工作特征分析，将根据加权和规则联合测试的表现与单独使用任一测试的表现进行比较。这种联合测试的方式比单独使用老年认知功能减退知情者问卷能更准确地筛查痴呆。简易精神状态检查表与老年认知功能减退知情者问卷联合使用时受试者工作特征曲线下面积为0.89，而单独使用老年认知功能减退知情者问卷时为0.82（卡方 = 10.63；P = 0.0011）。然而，将简易精神状态检查表与老年认知功能减退知情者问卷联合使用与单独使用简易精神状态检查表相比，筛查表现并无改善（受试者工作特征曲线下面积 = 0.89对0.86；卡方 = 3.54；P = 0.060）。
在该人群中，根据加权和规则进行认知测试与知情者报告联合使用，相比单独使用简易精神状态检查表并无优势。本研究的混合结果与麦金农和马利根的研究结果形成对比。
