Fernandez-Turrado T, Pascual-Millan L F, Aguilar-Palacio I, Burriel-Rosello A, Santolaria-Martinez L, Perez-Lazaro C
Universidad de Zaragoza. Facultad de Educacion, 50009 Zaragoza, Espana.
Rev Neurol. 2011 Mar 16;52(6):341-8.
Temporal orientation is a component of most screening tests for diagnosing cognitive impairment. Correct temporal orientation involves activating both semantic information (concepts of the calendar date) and episodic information (remembering the current date).
The aim of this study was to assess the diagnostic usefulness of a technique for evaluating temporal orientation, which was open-ended, and scoring the semantic and episodic information thus generated (0-10 points).
A total of 24 subjects without impairment, 77 patients with mild cognitive impairment (MCI) and 62 patients with dementia were evaluated by means of a 30-point mini-mental/mini-examination, semantic verbal fluency test, global deterioration scale, mini-mental-type temporal orientation and open-ended temporal orientation tests. The areas under the curve (aROC), sensitivity and specificity for dementia and cognitive impairment at any degree (MCI and dementia) were analysed.
Open-ended temporal orientation presented a greater area under the curve (aROC: 0.90) for discrimination between patients with dementia and without dementia (MCI and without impairment) and an aROC of 0.83 for discrimination between patients with MCI or dementia and without impairment. For dementia, with a cut-off point equal to or below 6, sensitivity was 0.96 and specificity was 0.68, and for MCI with dementia, with a cut-off point equal to or below 7, sensitivity was 0.72 and specificity was 0.92.
The usefulness, conciseness and strategic position of this technique in examining mental status make it suitable as an instrument for screening for cognitive impairment. It has a high level of sensitivity with low specificity for dementia and low sensitivity with high specificity for any degree of impairment.
时间定向是大多数用于诊断认知障碍的筛查测试的一个组成部分。正确的时间定向涉及激活语义信息（日历日期的概念）和情景信息（记住当前日期）。
本研究的目的是评估一种用于评估时间定向的技术的诊断效用，该技术为开放式，并对由此产生的语义和情景信息进行评分（0-10分）。
通过30分的简易精神状态/简易检查、语义言语流畅性测试、总体衰退量表、简易精神状态型时间定向和开放式时间定向测试，对24名无损伤受试者、77名轻度认知障碍（MCI）患者和62名痴呆患者进行了评估。分析了痴呆和任何程度认知障碍（MCI和痴呆）的曲线下面积（aROC）、敏感性和特异性。
开放式时间定向在区分痴呆患者与非痴呆患者（MCI和无损伤）时呈现出更大的曲线下面积（aROC：0.90），在区分MCI或痴呆患者与无损伤患者时aROC为0.83。对于痴呆，截断点等于或低于6时，敏感性为0.96，特异性为0.68；对于MCI合并痴呆，截断点等于或低于7时，敏感性为0.72，特异性为0.92。
该技术在检查精神状态方面的效用、简洁性和战略地位使其适合作为筛查认知障碍的工具。它对痴呆具有高敏感性但低特异性，对任何程度的损伤具有低敏感性但高特异性。
