Developmental and Lifespan Psychology, Vrije Universiteit Brussel, Brussels, Belgium.
Int J Geriatr Psychiatry. 2009 Oct;24(10):1094-100. doi: 10.1002/gps.2228.
This study was set up to investigate whether neuropsychological tests are able to predict conversion to AD among Mild Cognitive Impairment (MCI) patients.
At baseline the cognitive part of the Cambridge Examination for Mental Disorders of the Elderly (CAMCOG), the Mini Mental Status Examination (MMSE), the Geriatric Depression Scale (GDS), a Dutch variation of Rey's Auditory Verbal Learning Test, the Memory Impairment Screen plus (MISplus) and the Visual Association Test (VAT) were administered to 40 patients diagnosed with MCI. After 18 months, MCI-patients were reassessed and a follow-up diagnosis was established. Of those who were seen for follow-up (n = 31), seven fulfilled (NINCDS-ADRDA) criteria of probable AD, while 24 did not convert.
A binary logistic regression analysis showed that the MISplus contributed most to the prediction of conversion (OR = 0.28, 95% CI 0.099-0.790). With a cut-off of 2 out of 6, a positive predictive value of 71.5%, a negative predictive value of 91.5% and an overall diagnostic accuracy of 87.0% were achieved.
This prospective, longitudinal study shows that a score of 0 or 1 out of 6 on the MISplus may be a good indicator of future (within 18 months) progression to AD among MCI-patients.
本研究旨在探讨神经心理学测试是否能够预测轻度认知障碍（MCI）患者向 AD 的转化。
在基线时，对 40 名被诊断为 MCI 的患者进行了剑桥老年精神障碍检查（CAMCOG）的认知部分、简易精神状态检查（MMSE）、老年抑郁量表（GDS）、荷兰版 Rey 听觉言语学习测试、记忆障碍筛选加（MISplus）和视觉联想测试（VAT）。18 个月后，对 MCI 患者进行重新评估并确定随访诊断。在接受随访的患者中（n=31），有 7 人符合（NINCDS-ADRDA）可能 AD 的标准，而 24 人未转化。
二元逻辑回归分析显示，MISplus 对预测转化的贡献最大（OR=0.28，95%CI 0.099-0.790）。当截断值为 2 时，阳性预测值为 71.5%，阴性预测值为 91.5%，总诊断准确性为 87.0%。
这项前瞻性、纵向研究表明，MISplus 得分为 0 或 1 可能是 MCI 患者未来（18 个月内）向 AD 进展的一个良好指标。
