Department of Psychiatry, Tai Po Hospital, Tai Po, Hong Kong.
Int Psychogeriatr. 2013 Jul;25(7):1125-34. doi: 10.1017/S1041610213000161. Epub 2013 Apr 2.
This study evaluates which cognitive measure is best for predicting incident dementia in a population-based random sample of Chinese older adults without dementia over a five-year period.
A total of 787 community-dwelling Chinese older adults without dementia in Hong Kong were assessed at baseline (T0), at two years (T1), and at five years (T2).
The annual conversion rate to dementia was 1.6% and 6.3% for baseline normal participants and baseline mild cognitive impairment (MCI) participants, respectively. The Cantonese version of Mini-mental State Examination (CMMSE) scores declined significantly over time. In participants who progressed to dementia, Category Verbal Fluency Test (CVFT) scores dropped significantly from T0 to T1. A 1-SD drop of either CMMSE or CVFT in two years predicted dementia at five years with 91.5% sensitivity and 62.0% specificity. A stable CMMSE and CVFT at two years predicted a 91% chance of not progressing to clinical dementia at five years.
In this community sample of Chinese older adults, a decline in cognitive screening tests in short term (two years) offered useful information in predicting dementia conversion over a longer period.
本研究旨在评估在一项基于人群的、无痴呆的香港华裔老年人的随机样本中，哪种认知测量最适合预测五年内的痴呆发生。
共有 787 名居住在社区、无痴呆的香港华裔老年人在基线（T0）、两年（T1）和五年（T2）时进行评估。
基线正常参与者和基线轻度认知障碍（MCI）参与者的年转化率分别为 1.6%和 6.3%。粤语版简易精神状态检查（CMMSE）评分随时间显著下降。在进展为痴呆的参与者中，类别流畅性测验（CVFT）评分从 T0 到 T1 显著下降。在两年内 CMMSE 或 CVFT 下降 1 个标准差可预测五年时的痴呆，其敏感性为 91.5%，特异性为 62.0%。在两年内 CMMSE 和 CVFT 稳定，可预测五年时进展为临床痴呆的可能性为 91%。
在本项华裔老年人的社区样本中，认知筛查测试在短期内（两年）的下降在预测较长时间内的痴呆转化方面提供了有用的信息。
