Consultant Neurologist, Lanka Hospitals, Colombo, Sri Lanka.
Neurol India. 2010 Sep-Oct;58(5):702-7. doi: 10.4103/0028-3886.72167.
The Mini Mental State Examination (MMSE) is widely used for dementia screening but has several shortcomings such as prominent ceiling effects, inadequate sensitivity to mild cognitive impairment, and uneven sampling of the major cognitive domains.
In this study, we pilot a new dementia screening test - the Concise Cognitive Test (CONCOG) - designed to overcome the above short comings and describe the reliability measures and age, education, and gender effects. The CONCOG has a total score of 30, and has subtests for orientation, naming, registration, free recall and recognition of four words, semantic verbal fluency and copying.
Participants were screened to exclude those with any neurological or psychiatric disease, simultaneously administered the CONCOG, and a Hybrid Mini Mental State Examination (HMMSE) adapted from Folstein's MMSE and Ganguli's Hindi Mental State Examination.
The study sample had 204 subjects over the age of 60 years with a mean of 73 years and education level of 8 (4.5) years. Internal consistency for the CONCOG (Cronbach's alpha) was 0.74, inter-rater reliability (Kendall's tau-b) was 0.9, and the one-month test-retest reliability (Kendall's tau-b) was 0.7. Age and education level, but not gender, significantly influenced performance on both scales. Although the influence of age on the two scales was to a similar degree, the HMMSE was more affected by education than the CONCOG. Of 204 subjects, only 12 (5.7%) subjects obtained the maximum score on the CONCOG compared with 30 (14.1%) subjects on the HMMSE. The CONCOG took less than 10 minutes to complete in this sample. Age and education stratified norms are presented for the CONCOG.
The CONCOG is a reliable cognitive screening measure. It has negligible ceiling effects, is less influenced by education compared with the HMMSE, and offers subscale scores for the major cognitive domains.
简易精神状态检查（MMSE）被广泛用于痴呆症筛查，但存在几个缺点，如明显的天花板效应、对轻度认知障碍的敏感性不足，以及对主要认知领域的采样不均。
本研究中，我们引入了一种新的痴呆症筛查测试——简明认知测试（CONCOG），旨在克服上述缺点，并描述其可靠性测量指标以及年龄、教育和性别影响。CONCOG 的总分为 30 分，包含定向、命名、登记、自由回忆和四个单词的再认、语义流畅性和复制等子测验。
对参与者进行筛选，排除任何神经或精神疾病，同时进行 CONCOG 和改良混合简易精神状态检查（HMMSE）的测试，该量表改编自 Folstein 的 MMSE 和 Ganguli 的印地语精神状态检查。
研究样本包括 204 名年龄在 60 岁以上的患者，平均年龄为 73 岁，教育程度为 8（4.5）年。CONCOG 的内部一致性（Cronbach's alpha）为 0.74，评分者间信度（Kendall's tau-b）为 0.9，一个月内重测信度（Kendall's tau-b）为 0.7。年龄和教育程度对两种量表的表现均有显著影响，但性别无显著影响。虽然年龄对两种量表的影响程度相似，但 HMMSE 受教育程度的影响大于 CONCOG。在 204 名受试者中，仅有 12 名（5.7%）受试者在 CONCOG 上获得了满分，而在 HMMSE 上获得满分的受试者有 30 名（14.1%）。在本样本中，CONCOG 的完成时间不到 10 分钟。我们还呈现了 CONCOG 的年龄和教育分层常模。
CONCOG 是一种可靠的认知筛查工具。它的天花板效应较小，受教育程度的影响小于 HMMSE，并且提供了主要认知领域的子测验分数。
