Wang S-Y, Gong Z-K, Sen J, Han L, Zhang M, Chen W
Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu Province, China.
Eur Rev Med Pharmacol Sci. 2014;18(23):3665-72.
We wished to evaluate the usefulness of the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) in early detection of the Vascular Cognitive Impairment, No Dementia (VCIND) in patients with stroke. We also wanted to compare LOTCA with the Mini-Mental State Examination (MMSE).
Thirty patients with stroke and cognitive impairment comprised the cognitive impairment group. Another 30 patients with stroke and no cognitive impairment served as the stroke control group, while 30 healthy individuals served as the normal control group.
The age, gender, and education level were comparable among three study groups. All subjects were assessed with both tests. Total LOTCA scores strongly and positively correlated with total MMSE scores in patients with cognitive impairment (r = 0.934, p < 0.001). The correlations were also present between every sub-items of LOTCA and those of MMSE (p < 0.01). In addition, total scores and sub-item scores in LOTCA were significantly lower in the cognitive impairment group compared with both stroke control and normal control groups (p < 0.01), especially, with regard to scores of thinking operations, orientation, and visuomotor organization. The sub-item scores in LOTCA, including thinking operations, visuomotor organization, attention, orientation, and spatial perception were significantly lower in the stroke control group compared with normal control group (p < 0.01), especially in thinking operations and visuomotor organization. There is a good agreement between LOTCA and MMSE.
Compared with MMSE, LOTCA can detect VCIND earlier and more comprehensively, and can, thus, be used clinically for VCIND detection.
我们希望评估洛文斯顿作业疗法认知评定量表（LOTCA）在早期检测中风患者血管性认知障碍无痴呆（VCIND）方面的效用。我们还想将LOTCA与简易精神状态检查表（MMSE）进行比较。
30例患有中风和认知障碍的患者组成认知障碍组。另外30例患有中风但无认知障碍的患者作为中风对照组，30名健康个体作为正常对照组。
三个研究组之间的年龄、性别和教育水平具有可比性。所有受试者均接受了这两种测试。认知障碍患者的LOTCA总分与MMSE总分呈强正相关（r = 0.934，p < 0.001）。LOTCA的每个子项目与MMSE的子项目之间也存在相关性（p < 0.01）。此外，与中风对照组和正常对照组相比，认知障碍组的LOTCA总分及子项目得分均显著降低（p < 0.01），尤其是在思维操作、定向和视运动组织方面的得分。与正常对照组相比，中风对照组的LOTCA子项目得分，包括思维操作、视运动组织、注意力、定向和空间感知，均显著降低（p < 0.01），尤其是在思维操作和视运动组织方面。LOTCA与MMSE之间具有良好的一致性。
与MMSE相比，LOTCA能更早、更全面地检测出VCIND，因此可在临床上用于VCIND的检测。
