Institute of Gerontology & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Vechta, Vechta, Germany.
J Alzheimers Dis. 2013;34(4):813-34. doi: 10.3233/JAD-122128.
Many cognitive screening instruments have been developed during the last decades to detect mild cognitive dysfunction and dementia, and there is an ongoing discussion as to which tool should be used in which setting and which challenges have to be considered. Among other aspects, dependence on age is a recognized problem in screening tools which still has not found its way into common scoring procedures. Another aspect which has been handled very heterogeneously is which domain is represented in which proportion in the total score. Furthermore, screening ethnic minority patients has been identified as an important but so far widely unresolved matter. In this review, four cognitive screening tools that all follow a common, stringent concept and pay regard to some critical aspects are described: the DemTect, a "generic" tool; the PANDA for Parkinson's disease patients; the EASY, a non-verbal, culture-fair screening test for patients with migration background; and the MUSIC for patients with multiple sclerosis. All of these screening instruments have an age-correction, provide a total score in which the different subtests are weighted according to their individual sensitivity and specificity, and include tasks that are specifically aligned to the cognitive profile of the target group, including the EASY with non-verbal, culture-fair tasks to overcome language and cultural barriers. The development, main characteristics, data, and limitations of these tools are presented and discussed against the background of the current landscape of cognitive screening tools.
在过去几十年中,已经开发出许多认知筛查工具来检测轻度认知功能障碍和痴呆症,目前正在讨论应该在何种情况下使用哪种工具,以及需要考虑哪些挑战。除其他方面外,依赖年龄是筛查工具中一个公认的问题,但尚未纳入常见的评分程序。另一个方面是在总评分中,哪个领域以何种比例代表。此外,筛查少数民族患者已被确定为一个重要但迄今尚未得到解决的问题。在这篇综述中,描述了四种认知筛查工具,它们都遵循一个共同的严格概念,并考虑了一些关键方面:DemTect,一种“通用”工具;用于帕金森病患者的 PANDA;用于具有移民背景的患者的非言语、文化公平的 EASY 筛查测试;以及用于多发性硬化症患者的 MUSIC。所有这些筛查工具都有年龄校正,提供总评分,其中根据个别敏感性和特异性对不同子测试进行加权,并包括针对目标群体认知特征的特定任务,包括 EASY 中的非言语、文化公平任务,以克服语言和文化障碍。本文介绍并讨论了这些工具的开发、主要特点、数据和局限性,以了解认知筛查工具的当前情况。