Neurology Section, S. Gerardo Hospital, Monza, University of Milan Bicocca, Italy.
Parkinsonism Relat Disord. 2013 Dec;19(12):1160-3. doi: 10.1016/j.parkreldis.2013.08.008. Epub 2013 Aug 22.
The detection of cognitive decline in Parkinson's disease (PD), at the Mild Cognitive Impairment (MCI) stage, has prognostic and treatment implications. The Movement Disorders Society (MDS) has recently published criteria and guidelines for the diagnosis of possible and probable PD-MCI. In the present study we assessed the ability of the Scales for Outcomes in Parkinson's disease-Cognition (SCOPA-Cog) to discriminate possible PD-MCI cases from patients with PD-dementia (PDD) and from cognitively intact PD subjects. Hundred-and-thirteen consecutive PD patients underwent the MMSE, the Dementia Rating Scale and an interview on independence in daily living, and were classified as cognitively intact (n = 49), or as possible PD-MCI (n = 33) or PDD (n = 31), according to MDS criteria. Logistic regression analysis was carried out with PD-MCI diagnosis (yes/no) as an outcome variable, and age, education and the SCOPA-Cog total score as covariates. Classification of cases according to the regression model was used for constructing Receiver Operating Characteristic (ROC) curves. Area Under the Curve (AUC) was 0.92 [95% CI 0.86-0.98], for the differential diagnosis between PD-MCI and cognitively normal patients, and 0.97 [95% CI 0.80-1.00], for the differential diagnosis between PD-MCI and PDD. Sensitivity and specificity were 90% and 73% for the PD-MCI versus no cognitive impairment differentiation, at the cutpoint ≥24, and 93% and 97% for the PD-MCI versus PDD discrimination, at the cutpoint ≥17. The SCOPA-Cog is a quick and psychometrically sound PD-specific scale. Our findings support its use for the screening of possible PD-MCI.
帕金森病(PD)患者认知能力下降的检测,在轻度认知障碍(MCI)阶段,具有预后和治疗意义。运动障碍协会(MDS)最近发布了可能和可能 PD-MCI 的诊断标准和指南。在本研究中,我们评估了帕金森病认知量表(SCOPA-Cog)区分可能 PD-MCI 病例与 PD 痴呆(PDD)和认知正常 PD 患者的能力。113 例连续 PD 患者接受了简易精神状态检查(MMSE)、痴呆评定量表和日常生活独立性访谈,并根据 MDS 标准分为认知正常(n=49)、可能 PD-MCI(n=33)或 PDD(n=31)。将 PD-MCI 诊断(是/否)作为因变量,年龄、教育程度和 SCOPA-Cog 总分作为协变量,进行逻辑回归分析。根据回归模型对病例进行分类,用于构建受试者工作特征(ROC)曲线。曲线下面积(AUC)为 0.92 [95%置信区间 0.86-0.98],用于 PD-MCI 与认知正常患者的鉴别诊断,0.97 [95%置信区间 0.80-1.00],用于 PD-MCI 与 PDD 的鉴别诊断。在分界点≥24 时,PD-MCI 与无认知障碍的区分敏感性和特异性分别为 90%和 73%,在分界点≥17 时,PD-MCI 与 PDD 的区分敏感性和特异性分别为 93%和 97%。SCOPA-Cog 是一种快速且具有心理测量学意义的 PD 特异性量表。我们的研究结果支持其用于可能 PD-MCI 的筛查。