Hawkins Misty A W, Gathright Emily C, Gunstad John, Dolansky Mary A, Redle Joseph D, Josephson Richard, Moore Shirley M, Hughes Joel W
Department of Psychological Sciences, Kent State University, Kent, OH 44242, USA.
Department of Psychological Sciences, Kent State University, Kent, OH 44242, USA.
Heart Lung. 2014 Sep-Oct;43(5):462-8. doi: 10.1016/j.hrtlng.2014.05.011. Epub 2014 Jul 14.
To examine the ability of the Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to detect cognitive impairment in persons with heart failure (HF).
Although the MMSE and MoCA are commonly used screeners in HF, no research team has validated their performance against neuropsychological testing.
Participants were 106 patients with HF (49.1% male, 68.13 ± 9.82 years) who completed the MoCA, MMSE, and a full neuropsychological battery. Sensitivity and specificity were examined. Discriminant function analyses tested whether the screeners correctly detected cognitive impairment.
A MoCA score <25 and MMSE score of <28 yielded optimal sensitivity/specificity (.64/.66 and .70/.66, respectively). The MoCA correctly classified 65% of patients, Wilk's lambda = .91, χ(2)(1) = 9.89, p < .01, and the MMSE correctly classified 68%, Wilk's lambda = .87, χ(2)(1) = 14.26, p < .001.
In HF, both the MoCA and MMSE are useful in identifying the majority of patients with and without cognitive impairment. Both tests misclassified approximately one-third of patients, so continued monitoring and evaluation of patients is needed in conjunction with screening.
研究简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）检测心力衰竭（HF）患者认知障碍的能力。
尽管MMSE和MoCA是HF中常用的筛查工具，但尚无研究团队对照神经心理学测试验证其性能。
106例HF患者（男性占49.1%，年龄68.13±9.82岁）完成了MoCA、MMSE及全套神经心理学测试。检测了敏感性和特异性。判别函数分析测试筛查工具是否能正确检测出认知障碍。
MoCA评分<25分且MMSE评分<28分产生了最佳敏感性/特异性（分别为0.64/0.66和0.70/0.66）。MoCA正确分类了65%的患者，威尔克斯lambda系数=.91，χ²(1)=9.89，p<.01；MMSE正确分类了68%的患者，威尔克斯lambda系数=.87，χ²(1)=14.26，p<.001。
在HF患者中，MoCA和MMSE均有助于识别大多数有或无认知障碍的患者。两种测试均将约三分之一的患者误分类，因此在筛查的同时需要对患者进行持续监测和评估。
