Department of Family Medicine, National Taiwan University Hospital, and College of Medicine, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.
Arch Gerontol Geriatr. 2011 Jul-Aug;53(1):100-3. doi: 10.1016/j.archger.2010.06.008. Epub 2010 Jul 16.
The accuracy and consuming-time of screening methods are important factors in the early diagnosis of dementia. In this study, we aimed to know whether the eight-item test (including three-item recall, attention and calculation, subtracted from the mini-mental state examination (MMSE), clock drawing test (CDT), and instrumental activities of daily living (IADL) impairment or any combination of the above tests can be used as a quick and effective dementia screening tool. A total of 188 seniors aged over 60 years were enrolled at a geriatric clinic. The result revealed that a cutoff score of 6/7 in an eight-item scale had a sensitivity of 94.9% and a specificity of 59.1% in the detection of dementia. In terms of sensitivity and specificity, the eight-item scale performed better than a score of two in three-item recall (51.3%/87.3%), a score of one in three-item recall (83.3%/53.6%), CDT (39.0%/96.9%), mini-cognitive assessment instrument (Mini-Cog) test (53.7%/95.5%), a score of less than three in attention/calculation test (74.7%/77.3%), impairment of transportation or medication in IADL (67.2%/90.6%), and any impairment in IADL (77.2%/67.9%). In subgroup analysis, a cutoff score of 5/6 were adjusted for the low-education group. We conclude that an eight-item test is a sufficient and simple tool for the screening of early dementia in primary-care clinics focused on older people care.
筛查方法的准确性和耗时是痴呆早期诊断的重要因素。在这项研究中,我们旨在了解八项测试(包括 MMSE 减去的三项回忆、注意力和计算、画钟测试、日常生活活动的工具性方面的损害或上述任何测试的组合)是否可以作为一种快速有效的痴呆筛查工具。共有 188 名 60 岁以上的老年人在老年诊所登记。结果表明,八项量表的截断分数为 6/7 时,在检测痴呆方面的敏感性为 94.9%,特异性为 59.1%。在敏感性和特异性方面,八项量表的表现优于三项回忆中的两个分数(51.3%/87.3%)、一项回忆中的一个分数(83.3%/53.6%)、CDT(39.0%/96.9%)、迷你认知评估工具(Mini-Cog)测试(53.7%/95.5%)、注意力/计算测试中小于三个分数(74.7%/77.3%)、日常生活活动中的交通或药物损害(67.2%/90.6%)和日常生活活动中的任何损害(77.2%/67.9%)。在亚组分析中,针对低教育群体调整了 5/6 的截断分数。我们得出结论,八项测试是针对以老年人为重点的初级保健诊所进行早期痴呆筛查的一种充分且简单的工具。