Department of Neurology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey.
Int Psychogeriatr. 2013 Mar;25(3):403-12. doi: 10.1017/S1041610212001780. Epub 2012 Nov 9.
The aim was to develop a brief screening battery, Cognitive State Test (COST), for detecting the presence of dementia in both illiterate and literate patients and to assess its validity and reliability.
COST is a cognitive screening tool that consists of almost all cognitive domains. It takes 5-7 minutes to administer, and has a maximum score of 30. Data were obtained from 114 healthy volunteers and 74 Alzheimer dementia (AD) patients. Subjects' age divided into two groups: A1: <65 years; and A2: ≥65 years and their education level divided into three groups: E1: illiterate; E2: 1-5 years; and E3: ≥6 years. For assessing concurrent validity, total COST score was compared to the Clinical Dementia Rating (CDR), the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and Basic Activities of Daily Living (BADL). Sensitivity and specificity were determined through a discriminant analysis using the Receiver Operating Characteristic (ROC) curves. Internal consistency was measured using Cronbach's coefficient α.
For normal and AD subjects, mean age was 64.9±9.8 years (50 women and 64 men) and 67.2±13.2 years (55 women and 19 men), respectively. Schooling ranged from 0-15 years (mean 5.7±4.2 and 3.3±3.8 years, respectively), and 21 and 37 subjects were illiterate, respectively. The COST significantly and positively correlated with MMSE and MoCA, and significantly and inversely correlated with CDR, the Geriatric Depression Scale (GDS), and BADL. In the E1, E2, and E3 education groups, the optimal cut-off points of COST chosen for diagnosis of AD were 23/24 (sensitivity: 81%, specificity: 99%), 24/25 (sensitivity: 75%, specificity: 86%), and 26/27 (sensitivity: 77%, specificity: 84%), respectively. When illiterate and literate subjects were then pooled, the optimal cut-off score of COST was 24/25, which yielded a sensitivity of 81% and a specificity of 87%. Reliability of the COST was good (0.86).
The COST is a valid and reliable screening battery for detection of dementia both in the illiterate and the literate Alzheimer patients.
本研究旨在开发一种简短的筛选工具,即认知状态测试(COST),用于检测文盲和识字患者是否存在痴呆,并评估其有效性和可靠性。
COST 是一种认知筛查工具,几乎涵盖了所有认知领域。它的实施时间为 5-7 分钟,满分为 30 分。本研究的数据来自 114 名健康志愿者和 74 名阿尔茨海默病(AD)患者。根据年龄将受试者分为两组:A1:<65 岁;A2:≥65 岁。根据教育水平将受试者分为三组:E1:文盲;E2:1-5 年;E3:≥6 年。为了评估其同时效度,将 COST 总分与临床痴呆评定量表(CDR)、简易精神状态检查(MMSE)、蒙特利尔认知评估量表(MoCA)和基本日常生活活动量表(BADL)进行了比较。通过使用接收者操作特征(ROC)曲线进行判别分析,确定了敏感性和特异性。使用 Cronbach 系数 α 评估内部一致性。
在正常和 AD 受试者中,平均年龄分别为 64.9±9.8 岁(女性 50 人,男性 64 人)和 67.2±13.2 岁(女性 55 人,男性 19 人)。受教育程度从 0-15 年不等(平均 5.7±4.2 年和 3.3±3.8 年),21 人和 37 人是文盲。COST 与 MMSE 和 MoCA 呈显著正相关,与 CDR、老年抑郁量表(GDS)和 BADL 呈显著负相关。在 E1、E2 和 E3 教育组中,COST 用于诊断 AD 的最佳截断点分别为 23/24(敏感性:81%,特异性:99%)、24/25(敏感性:75%,特异性:86%)和 26/27(敏感性:77%,特异性:84%)。当文盲和识字受试者合并时,COST 的最佳截断分数为 24/25,其敏感性为 81%,特异性为 87%。COST 的可靠性良好(0.86)。
COST 是一种有效且可靠的筛查工具,可用于检测文盲和识字的阿尔茨海默病患者的痴呆症。