Standish Timothy I M, Molloy D William, Cunje Alwin, Lewis David L
St Peter's Centre for Studies in Aging, St Peter's Hospital, Hamilton, Ontario, Canada.
Int J Geriatr Psychiatry. 2007 Mar;22(3):189-94. doi: 10.1002/gps.1659.
Cognitive screening instruments are either too long for routine clinical use or not sensitive to distinguish mild cognitive impairment (MCI) from normal cognition (NC) or dementia.
To evaluate the sensitivity and specificity of the AB Cognitive Screen (ABCS) and its subtests with a view to improving its ability to differentiate between dementia, MCI and NC. The influence of age and education on sensitivity and specificity is also examined.
Cross-sectional study.
Participants with dementia and MCI were recruited from those presenting to four specialty geriatric clinics in southern Ontario. Participants with NC were recruited from the family and friends of patients. A comprehensive geriatric assessment was done including ABCS, SMMSE and 15 point Geriatric Depression Scale. Analysis of variance and receiver operating characteristic (ROC) curves compared test scores. SMMSE scores were also analysed for comparison purposes.
Three hundred and two participants had dementia, 166 had MCI and 174 had NC. ABCS total scores were significantly different between NC and MCI (mean difference 7.1, 1.8-12.5 CI, p = 0.000) while SMMSE scores were not (mean difference 0.5, -0.7-1.7, p < 0.628). Of individual ABCS subtests, verbal fluency and delayed recall were most sensitive to differences between NC and MCI. ROC curve analysis, which presents sensitivity and specificity, showed verbal fluency was better than delayed recall in distinguishing between NC and MCI, among participants 75 years of age or older.
The AB Cognitive Screen (ABCS) can be administered in 3-5 min. The SMMSE and ABCS total and subtests significantly distinguished between dementia and MCI or NC. Verbal fluency and delayed recall were best at distinguishing between MCI and NC. The analysis illustrates how each subtest contributes to the sensitivity of the ABCS and suggests ways that sensitivity might be improved.
认知筛查工具要么过长不适用于常规临床使用，要么对区分轻度认知障碍（MCI）与正常认知（NC）或痴呆不敏感。
评估AB认知筛查（ABCS）及其子测试的敏感性和特异性，以提高其区分痴呆、MCI和NC的能力。还研究了年龄和教育程度对敏感性和特异性的影响。
横断面研究。
从安大略省南部四家专科老年诊所的就诊者中招募痴呆和MCI患者。从患者的家人和朋友中招募NC患者。进行了全面的老年评估，包括ABCS、简易精神状态检查表（SMMSE）和15项老年抑郁量表。采用方差分析和受试者工作特征（ROC）曲线比较测试分数。为作比较也分析了SMMSE分数。
302名参与者患有痴呆，166名患有MCI，174名患有NC。NC和MCI之间的ABCS总分有显著差异（平均差异7.1，95%置信区间1.8 - 12.5，p = 0.000），而SMMSE分数无显著差异（平均差异0.5，95%置信区间 - 0.7 - 1.7，p < 0.628）。在ABCS各个子测试中，语言流畅性和延迟回忆对NC和MCI之间的差异最敏感。呈现敏感性和特异性的ROC曲线分析表明，在75岁及以上的参与者中，语言流畅性在区分NC和MCI方面优于延迟回忆。
AB认知筛查（ABCS）可在3 - 5分钟内完成。SMMSE以及ABCS总分和子测试在区分痴呆与MCI或NC方面有显著差异。语言流畅性和延迟回忆在区分MCI和NC方面表现最佳。该分析说明了每个子测试如何对ABCS的敏感性产生影响，并提出了可能提高敏感性的方法。
