Carnero-Pardo Cristóbal, Cruz-Orduña Isabel, Espejo-Martínez Beatriz, Martos-Aparicio Carolina, López-Alcalde Samuel, Olazarán Javier
Neurology Service, Virgen de las Nieves University Hospital, Granada, Spain ; FIDYAN Neurocenter, Granada, Spain.
Int J Alzheimers Dis. 2013;2013:285462. doi: 10.1155/2013/285462. Epub 2013 Aug 28.
Objectives. To study the utility of the Mini-Cog test for detection of patients with cognitive impairment (CI) in primary care (PC). Methods. We pooled data from two phase III studies conducted in Spain. Patients with complaints or suspicion of CI were consecutively recruited by PC physicians. The cognitive diagnosis was performed by an expert neurologist, after formal neuropsychological evaluation. The Mini-Cog score was calculated post hoc, and its diagnostic utility was evaluated and compared with the utility of the Mini-Mental State (MMS), the Clock Drawing Test (CDT), and the sum of the MMS and the CDT (MMS + CDT) using the area under the receiver operating characteristic curve (AUC). The best cut points were obtained on the basis of diagnostic accuracy (DA) and kappa index. Results. A total sample of 307 subjects (176 CI) was analyzed. The Mini-Cog displayed an AUC (±SE) of 0.78 ± 0.02, which was significantly inferior to the AUC of the CDT (0.84 ± 0.02), the MMS (0.84 ± 0.02), and the MMS + CDT (0.86 ± 0.02). The best cut point of the Mini-Cog was 1/2 (sensitivity 0.60, specificity 0.90, DA 0.73, and kappa index 0.48 ± 0.05). Conclusions. The utility of the Mini-Cog for detection of CI in PC was very modest, clearly inferior to the MMS or the CDT. These results do not permit recommendation of the Mini-Cog in PC.
目的。研究简易认知筛查量表（Mini-Cog）检测基层医疗（PC）中认知障碍（CI）患者的效用。方法。我们汇总了在西班牙进行的两项III期研究的数据。基层医疗医生连续招募有CI主诉或疑似CI的患者。经过正式的神经心理学评估后，由专业神经科医生进行认知诊断。事后计算Mini-Cog评分，并使用受试者操作特征曲线下面积（AUC）评估其诊断效用，并与简易精神状态检查表（MMS）、画钟试验（CDT）以及MMS与CDT之和（MMS + CDT）的效用进行比较。根据诊断准确性（DA）和kappa指数获得最佳切点。结果。共分析了307名受试者（176名CI患者）的样本。Mini-Cog的AUC（±标准误）为0.78±0.02，显著低于CDT（0.84±0.02）、MMS（0.84±0.02）和MMS + CDT（0.86±0.02）的AUC。Mini-Cog的最佳切点为1/2（灵敏度0.60，特异度0.90，DA 0.73，kappa指数0.48±0.05）。结论。Mini-Cog在基层医疗中检测CI的效用非常有限，明显低于MMS或CDT。这些结果不支持在基层医疗中推荐使用Mini-Cog。
