Department of Geriatric Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Geriatr Gerontol Int. 2010 Apr;10(2):183-90. doi: 10.1111/j.1447-0594.2009.00576.x.
It is highly desirable to develop a neuropsychological screening test which is sensitive to the early stage of Alzheimer's disease (AD), and is easy to administer at the primary care physician's (PCP's) office.
Participants were 128 AD patients and 54 healthy volunteers. Brief cognitive screening tests were administered to the participants including the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Verbal Fluency Test (VFT), a Verbal Category Cued Memory test (CCMT) and the Scenery Picture Memory Test (SPMT). In the SPMT, a scenery picture of a living room containing 23 familiar objects was used. The administration of the SPMT comprised the first shallow memory session (Pict 1) and the second deep memory session (Pict 2). The area under the receiver-operator curve (AUC) was used to compare the efficacy of SPMT with other cognitive tests.
Pict 1, which requires less than 2 min to complete, had the same AUC as Pict 2, and showed significantly larger AUC than MMSE, CDT and VFT for all (MMSE 19-23) and very mild (MMSE > or = 24) AD patients. When we conducted the similar analysis separately for those younger than 75 years and those aged 75 years or older, we obtained the same results as above among the older age group. Pict 1 showed larger AUC than CCMT in overall sample and also in the older age group, although the difference was not statistically significant.
The SPMT could be useful for detection of mild and very mild AD in settings even where time is limited.
开发一种对阿尔茨海默病(AD)早期敏感、易于在初级保健医生(PCP)办公室进行的神经心理筛查测试是非常可取的。
参与者为 128 例 AD 患者和 54 名健康志愿者。对参与者进行简短的认知筛查测试,包括简易精神状态检查(MMSE)、画钟试验(CDT)、词语流畅性测试(VFT)、词语类别线索记忆测试(CCMT)和场景图片记忆测试(SPMT)。在 SPMT 中,使用了一个包含 23 个熟悉物体的客厅场景图片。SPMT 的实施包括第一次浅层记忆测试(Pict 1)和第二次深层记忆测试(Pict 2)。受试者工作特征曲线下的面积(AUC)用于比较 SPMT 与其他认知测试的疗效。
完成 Pict 1 所需时间不到 2 分钟,其 AUC 与 Pict 2 相同,并且对于所有(MMSE 19-23)和轻度(MMSE≥24)AD 患者,其 AUC 明显大于 MMSE、CDT 和 VFT。当我们分别对年龄小于 75 岁和年龄大于等于 75 岁的患者进行类似分析时,在年龄较大的患者组中也得到了上述相同的结果。在整个样本中以及在年龄较大的患者组中,Pict 1 的 AUC 均大于 CCMT,尽管差异无统计学意义。
即使在时间有限的情况下,SPMT 也可用于检测轻度和非常轻度的 AD。