Division of Geriatric Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Biomed Res Int. 2013;2013:186106. doi: 10.1155/2013/186106. Epub 2013 Jul 11.
This study compares the usefulness of Montreal Cognitive Assessment (MoCA) to Standardized Mini-Mental Status Exam (SMMSE) for diagnosing mild cognitive impairment (MCI) in Type 2 diabetes mellitus (DM) population.
This prospective pilot study enrolled 30 community dwelling adults with Type 2 DM aged 50 years and above. Subjects were assessed using both the SMMSE and MoCA for MCI. In all subjects, depression and dementia were ruled out using the DSM IV criteria, and a functional assessment was done. MCI was diagnosed using the standard test, the European consortium criteria. Sensitivity and specificity analysis, positive and negative predictive values, likelihood ratios and Kappa statistic were calculated.
In comparison to consortium criteria, the sensitivity and specificity of MoCA were 67% and 93% in identifying individuals with MCI, and SMMSE were 13% and 93%, respectively. The positive and negative predictive values for MoCA were 84% and 56%, and for SMMSE were 66% and 51%, respectively. Kappa statistics showed moderate agreement between MoCA and consortium criteria (kappa = 0.4) and a low agreement between SMMSE and consortium criteria (kappa = 0.07).
In this pilot study, MoCA appears to be a better screening tool than SMMSE for MCI in the diabetic population.
本研究比较蒙特利尔认知评估（MoCA）和标准化简易精神状态检查（SMMSE）在诊断 2 型糖尿病（DM）患者轻度认知障碍（MCI）中的作用。
这项前瞻性的初步研究纳入了 30 名 50 岁及以上的社区居住的 2 型 DM 成年患者。对所有患者均采用 SMMSE 和 MoCA 进行 MCI 评估。根据 DSM-IV 标准，所有患者均排除了抑郁和痴呆，并进行了功能评估。采用标准测试即欧洲联盟标准来诊断 MCI。计算了敏感性和特异性分析、阳性和阴性预测值、似然比和 Kappa 统计。
与联盟标准相比，MoCA 识别 MCI 患者的敏感性和特异性分别为 67%和 93%，SMMSE 分别为 13%和 93%。MoCA 的阳性和阴性预测值分别为 84%和 56%，SMMSE 分别为 66%和 51%。Kappa 统计显示 MoCA 与联盟标准之间具有中度一致性（kappa=0.4），而 SMMSE 与联盟标准之间的一致性较低（kappa=0.07）。
在这项初步研究中，MoCA 似乎是 DM 患者 MCI 的比 SMMSE 更好的筛查工具。
