[初级保健中应用的认知测试的诊断收益。筛查测试的一致性和有效性]

[Diagnostic yield of cognitive tests applied in primary care. Consistency and validity of screening tests].

作者信息

Lorente Aznar Teófilo, Olivera Pueyo Francisco Javier, Benabarre Ciria Sergio, Rodríguez Torrente Mariano, Solans Aisa Beatriz, Giménez Baratech Ana Carmen

机构信息

Centro de Salud de Sabiñánigo, Huesca, España.

出版信息

Aten Primaria. 2010 Apr;42(4):226-32. doi: 10.1016/j.aprim.2009.07.014. Epub 2009 Nov 11.

DOI:10.1016/j.aprim.2009.07.014

PMID:19906463

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7024413/

Abstract

OBJECTIVE

To estimate the prevalence of cognitive impairment in elderly people living in the community. To assess the diagnostic yield of the main cognitive screening tests in Primary Care: the Mini Mental State Examination (MMSE), the Clock Drawing Test (CDT), the Verbal Fluency Test (VFT) and the Informant Questionnaire test (IQ). We also calculated their correlation and validity.

DESIGN

Descriptive study based on a personal interview by professionals using a standardised method to assess cognitive impairment.

PARTICIPANTS

A total of 293 men and women, who were older than 64 years old and residing in the province of Huesca. The sample was recruited by systematic random sampling from the database of personal health care card.

MAIN MEASUREMENTS

We analysed social and demographic variables (age, educational level, marital status) and the assessment of cognitive impairment by means of MMSE, CDT, VF, IQ tests.

RESULTS

The prevalence of cognitive impairment with MMSE was 18.1% (95% CI: 15.3-24.4%). The correlation between MMSE and the other cognitive screening tests was moderate: CDT kappa=0.40; VF kappa=0.33; IQ kappa=0.36. Using the MMSE as a gold standard and the prior diagnosis of CI, the sensitivity of CDT was 78.3% and the specificity was 76.9%, 80%; there was 70% sensitivity and 76.7% specificity for the VF; and 71.4% for IQ respectively. The area under the VF ROC curve was significantly higher than the other tests.

CONCLUSIONS

The agreement between cognitive impairment screening tests was moderate. The VF yielded better diagnostic accuracy.

摘要

目的

评估社区老年人认知障碍的患病率。评估初级保健中主要认知筛查测试的诊断效能：简易精神状态检查表（MMSE）、画钟试验（CDT）、语言流畅性测试（VFT）和 informant 问卷测试（IQ）。我们还计算了它们的相关性和效度。

设计

基于专业人员采用标准化方法进行个人访谈以评估认知障碍的描述性研究。

参与者

总共 293 名年龄在 64 岁以上且居住在韦斯卡省的男性和女性。样本通过从个人医疗保健卡数据库中系统随机抽样招募。

主要测量指标

我们分析了社会和人口统计学变量（年龄、教育水平、婚姻状况），并通过 MMSE、CDT、VF、IQ 测试评估认知障碍。

结果

MMSE 评估的认知障碍患病率为 18.1%（95%置信区间：15.3 - 24.4%）。MMSE 与其他认知筛查测试之间的相关性为中等：CDT 的卡帕值 = 0.40；VF 的卡帕值 = 0.33；IQ 的卡帕值 = 0.36。以 MMSE 作为金标准和 CI 的先前诊断，CDT 的敏感性为 78.3%，特异性为 76.9%，80%；VF 的敏感性为 70%，特异性为 76.7%；IQ 的敏感性分别为 71.4%。VF 的 ROC 曲线下面积显著高于其他测试。