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居住在中国东部的老年人中蒙特利尔认知评估中文版的跨文化差异及验证:初步研究结果。

Cross-cultural difference and validation of the Chinese version of Montreal Cognitive Assessment in older adults residing in Eastern China: preliminary findings.

机构信息

Department of Mental Health, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou, China.

出版信息

Arch Gerontol Geriatr. 2013 Jan-Feb;56(1):38-43. doi: 10.1016/j.archger.2012.05.008. Epub 2012 Jun 13.

Abstract

To evaluate the psychometric properties of the Chinese Montreal Cognitive Assessment (MoCA-C) and assess cross-cultural differences in a community-based cohort residing in the Eastern China. The study included 72 patients with Alzheimer's disease (AD), 84 patients with mild cognitive impairment (MCI) and 146 cognitively normal controls. Sensitivities and specificities were calculated using the recommended cut-off scores. Receiver operator characteristic (ROC) curve analyses were performed to determine optimal sensitivity and specificity. Criterion validity, inter-rater, test-retest reliability and internal consistencies of the MoCA-C were examined, and clinical observations made. The influence of age, education level and gender on MoCA score was examined. Using the recommended cut-off score of 26, the area under the ROC (AUC) for predicting MCI groups using the MoCA-C was 0.930 (95%CI: 0.894; 0.965). The MoCA-C demonstrated 92% sensitivity and 85% specificity in screening for MCI. Cultural differences from the original MoCA affected the test response rate. The MoCA-C appears to have utility as a cognitive screen for early detection of AD and for MCI and warrants further investigation regarding its applicability in primary care settings in elderly Chinese people. It will be necessary to revise the contents of the questionnaire to account for by local characteristics.

摘要

为评估中文蒙特利尔认知评估(MoCA-C)的心理测量特性,并评估居住在中国东部的社区人群中的跨文化差异。该研究纳入了 72 例阿尔茨海默病(AD)患者、84 例轻度认知障碍(MCI)患者和 146 例认知正常对照者。使用推荐的截断值计算敏感性和特异性。进行受试者工作特征(ROC)曲线分析以确定最佳的敏感性和特异性。检验 MoCA-C 的效标效度、评定者间信度、重测信度和内部一致性,并进行临床观察。检验年龄、教育水平和性别对 MoCA 评分的影响。使用推荐的 26 分截断值,MoCA-C 预测 MCI 组的 ROC 曲线下面积(AUC)为 0.930(95%CI:0.894;0.965)。MoCA-C 筛查 MCI 的敏感性为 92%,特异性为 85%。与原始 MoCA 相比,文化差异影响了测试反应率。MoCA-C 似乎可用作 AD 和 MCI 的认知筛查工具,值得进一步研究其在我国老年人群中的初级保健环境中的适用性。有必要根据当地特点修订问卷内容。

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