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具有脑血管危险因素患者的认知障碍:简易精神状态检查表与蒙特利尔认知评估的比较

Cognitive impairments in patients with cerebrovascular risk factors: a comparison of Mini Mental Status Exam and Montreal Cognitive Assessment.

作者信息

Sikaroodi Hajir, Yadegari Samira, Miri Seyyed Roohollah

机构信息

Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Clin Neurol Neurosurg. 2013 Aug;115(8):1276-80. doi: 10.1016/j.clineuro.2012.11.026. Epub 2013 Jan 3.

Abstract

OBJECTIVE AND BACKGROUND

Recent evidence suggests that cerebrovascular risk factors are contributing factors, not only to vascular cognitive decline, but also for Alzheimer's disease. The study aim was to compare Montreal Cognitive Assessment (MoCA) and MMSE tests in subjects with cerebrovascular risk factors.

PATIENTS AND METHODS

Fifty patients with cerebrovascular risk factors were administrated the MMSE and MoCA tests. Data collected for all subjects and the results were compared.

RESULTS

Cognitive impairments revealed on both tests were more frequent in females, and correlated with the level of education (for MoCA r=0.75, p=0.001 and for MMSE r=0.662, p=0.001). Mean values of MoCA score were significantly lower in patients with two or more cerebrovascular risk factors compared with those with only one risk factor (19.92±5.99 versus 23.81±4.06; p=0.049), a finding that was not evidenced by MMSE.

CONCLUSIONS

The most frequent impaired domain in MMSE (for scores both less and more than 26) was attention; but in MoCA the most frequent impaired domains were delayed recall (for scores above 26), and visuo-executive (for scores≤26), which is a common domain involved in vascular cognitive decline. MoCA may be superior to MMSE in early detection of cognitive decline in patients with vascular risk factors.

摘要

目的与背景

近期证据表明,脑血管危险因素不仅是血管性认知功能减退的促成因素,也是阿尔茨海默病的促成因素。本研究旨在比较蒙特利尔认知评估量表(MoCA)和简易精神状态检查表(MMSE)在有脑血管危险因素的受试者中的表现。

患者与方法

对50例有脑血管危险因素的患者进行MMSE和MoCA测试。收集所有受试者的数据并比较结果。

结果

两项测试中发现的认知障碍在女性中更为常见,且与教育程度相关(MoCA的r = 0.75,p = 0.001;MMSE的r = 0.662,p = 0.001)。与仅有一个危险因素的患者相比,有两个或更多脑血管危险因素的患者MoCA评分的平均值显著更低(19.92±5.99对23.81±4.06;p = 0.049),而MMSE未显示出这一结果。

结论

MMSE中最常受损的领域(评分低于和高于26分的情况)是注意力;但在MoCA中,最常受损的领域是延迟回忆(评分高于26分)和视觉执行功能(评分≤26分),这是血管性认知功能减退中常见的一个领域。在早期检测有血管危险因素患者的认知功能减退方面,MoCA可能优于MMSE。

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