Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada.
Int Psychogeriatr. 2011 Sep;23(7):1107-15. doi: 10.1017/S1041610210002450. Epub 2011 Feb 1.
The Montreal Cognitive Assessment (MoCA) can be used to quantify cognitive ability in older persons undergoing screening for cognitive impairment. Although highly sensitive in detecting mild cognitive impairment, its measurement precision is weakest among persons with milder forms of impairment. We sought to overcome this limitation by integrating information from the Mini-Mental State Examination (MMSE) into the calculation of cognitive ability.
Data from 185 geriatric outpatients screened for cognitive impairment with the MoCA and the MMSE were Rasch analyzed to evaluate the extent to which the MMSE items improved measurement precision in the upper ability ranges of the population.
Adding information from the MMSE resulted in a 13.8% (13.3-14.3%) reduction in measurement error, with significant improvements in all quartiles of patient ability. The addition of three-word repetition and recall, copy pentagons, repeat sentence, and write sentence improved measurement of cognition in the upper levels of ability.
The algorithm presented here maximizes the yield of available clinical data while improving measurement of cognitive ability, which is particularly important for tracking changes over time in patients with milder levels of impairment.
蒙特利尔认知评估（MoCA）可用于量化认知能力，对接受认知障碍筛查的老年人进行评估。尽管在检测轻度认知障碍方面非常敏感，但在认知障碍程度较轻的人群中，其测量精度最差。我们试图通过将来自简易精神状态检查（MMSE）的信息整合到认知能力的计算中，来克服这一局限性。
对 185 名接受 MoCA 和 MMSE 认知障碍筛查的老年门诊患者的数据进行了 Rasch 分析，以评估 MMSE 项目在人群的较高能力范围内提高测量精度的程度。
从 MMSE 中获取信息可使测量误差降低 13.8%（13.3-14.3%），所有患者能力四分位数均有显著改善。添加三词重复和回忆、临摹五边形、重复句子和写句子可改善认知能力的测量。
这里提出的算法最大限度地利用了可用的临床数据，同时提高了认知能力的测量，这对于跟踪轻度认知障碍患者随时间的变化尤为重要。
