Karrasch M, Sinervä E, Grönholm P, Rinne J, Laine M
Department of Psychology, Abo Akademi University, Abo, Finland.
Acta Neurol Scand. 2005 Mar;111(3):172-9. doi: 10.1111/j.1600-0404.2005.00380.x.
The aim of the study was to examine the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test performances cross-sectionally in patients suffering from amnestic mild cognitive impairment (MCI) and mild Alzheimer's disease (AD). Moreover, we wanted to determine the sensitivity to amnestic MCI and mild AD, as well as the specificity of different CERAD subtests in our study groups.
Fifteen healthy elderly individuals, 15 amnestic MCI patients and 15 probable AD patients suffering from mild dementia were tested with the CERAD neurocognitive dementia screening test.
Significant differences were found in all CERAD tests except Constructional praxis (copy) and Clock drawing between the controls and the AD group. The MCI group was differentiated from the controls only in the Wordlist learning test. In the language tests the sensitivity to MCI and AD was quite low and the specificity very high. In the savings scores the sensitivity to AD was high, but the specificity rather low. The Wordlist recognition test screened no false positives using the current cut-off score and the sensitivity to AD was 0.6, but only one MCI patient was detected using the current cut-off score. Raising the cut-off score also raised the sensitivity to MCI without dramatic loss of specificity. Cut-off scores for the Wordlist learning test and Wordlist delayed recall, which have been found to differentiate normal aging from dementia, are lacking in the Finnish CERAD. The current data indicates that the Wordlist learning test might be relatively sensitive to MCI.
The results indicate that the Finnish CERAD test battery with its current cut-off scores has low sensitivity to MCI, and using it as a sole cognitive screening instrument for MCI and preclinical dementia might result in false negatives.
本研究旨在对遗忘型轻度认知障碍(MCI)和轻度阿尔茨海默病(AD)患者进行阿尔茨海默病注册联合会(CERAD)测试表现的横断面研究。此外,我们想确定在我们的研究组中,不同CERAD子测试对遗忘型MCI和轻度AD的敏感性以及特异性。
对15名健康老年人、15名遗忘型MCI患者和15名患有轻度痴呆的可能AD患者进行了CERAD神经认知痴呆筛查测试。
除结构实践(临摹)和画钟测试外,对照组与AD组在所有CERAD测试中均存在显著差异。MCI组仅在单词表学习测试中与对照组有所区分。在语言测试中,对MCI和AD的敏感性相当低,而特异性非常高。在节省分数方面,对AD的敏感性高,但特异性相当低。使用当前的临界值,单词表识别测试未筛查出假阳性,对AD的敏感性为0.6,但使用当前临界值仅检测到1例MCI患者。提高临界值也提高了对MCI的敏感性,而特异性没有显著损失。芬兰CERAD缺乏用于区分正常衰老与痴呆的单词表学习测试和单词表延迟回忆的临界值。目前的数据表明,单词表学习测试可能对MCI相对敏感。
结果表明,具有当前临界值的芬兰CERAD测试组合对MCI的敏感性较低,将其作为MCI和临床前期痴呆的唯一认知筛查工具可能会导致假阴性。