Larner A J
1 Cognitive Function Clinic, Walton Centre for Neurology and Neurosurgery, Liverpool, United Kingdom.
J Geriatr Psychiatry Neurol. 2017 Mar;30(2):104-108. doi: 10.1177/0891988716673469. Epub 2016 Dec 26.
The diagnostic accuracy of the short Montreal Cognitive Assessment (s-MoCA), a cognitive screening instrument recently derived by item response theory and computerized adaptive testing from the original MoCA, for the diagnosis of dementia and mild cognitive impairment (MCI) was assessed in 2 patient cohorts referred to a dedicated memory clinic in order to examine the validity and reproducibility of s-MoCA. Diagnosis used standard clinical diagnostic criteria for dementia and MCI as reference standard (prevalence of cognitive impairment = 0.43 and 0.46 in each cohort, respectively). There were significant differences in s-MoCA test scores for dementia, MCI, and subjective memory impairment ( P ≤ .01), and s-MoCA effect sizes (Cohen d) were medium to large (range: 0.65-1.42) for the diagnosis of dementia and MCI. Using the cut-off for s-MoCA specified in the index study, it proved highly sensitive (>0.9) for diagnosis of dementia but with poor specificity (≤0.25), with moderate sensitivity (≥0.75) and specificity (≥0.60) for diagnosis of MCI. In conclusion, in these pragmatic diagnostic test accuracy studies, s-MoCA proved acceptable and sensitive for the diagnosis of cognitive impairment in a memory clinic setting, with a performance similar to that of the original MoCA.
简短的蒙特利尔认知评估量表（s-MoCA）是最近通过项目反应理论和计算机自适应测试从原始MoCA衍生而来的一种认知筛查工具。为了检验s-MoCA的有效性和可重复性，在两个转诊至专门记忆诊所的患者队列中评估了其对痴呆和轻度认知障碍（MCI）的诊断准确性。诊断采用痴呆和MCI的标准临床诊断标准作为参考标准（每个队列中认知障碍的患病率分别为0.43和0.46）。痴呆、MCI和主观记忆障碍的s-MoCA测试分数存在显著差异（P≤0.01），s-MoCA效应大小（Cohen d）对于痴呆和MCI的诊断为中等至较大（范围：0.65 - 1.42）。使用指数研究中规定的s-MoCA截断值，其对痴呆诊断的敏感性很高（>0.9），但特异性较差（≤0.25），对MCI诊断的敏感性中等（≥0.75）且特异性中等（≥0.60）。总之，在这些实用的诊断测试准确性研究中，s-MoCA在记忆诊所环境中对认知障碍的诊断被证明是可接受且敏感的，其表现与原始MoCA相似。
