Hobson Peter, Rohoma Kamel H, Wong Stephen P, Kumwenda Mick J
Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, NHS Wales, Bodelwyddan, UK.
Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, NHS Wales, Bodelwyddan, UK; Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Dement Geriatr Cogn Dis Extra. 2016 Dec 5;6(3):541-548. doi: 10.1159/000450784. eCollection 2016 Sep-Dec.
BACKGROUND/AIMS: We tested the utility of the Mini-Addenbrooke's Cognitive Examination (M-ACE) in a cohort of older adults with chronic kidney disease (CKD) and diabetes.
The M-ACE was administered to 112 CKD and diabetes patients attending a nephrology clinic. Cognitive impairment was based upon patient, informant, and case review, neuropsychological assessment, and application of criteria for mild cognitive impairment (MCI) and the Diagnostic and Statistical Manual of Mental Disorders, fifth edition for dementia. The M-ACE was also compared to the Mini-Mental State Examination (MMSE).
Upon assessment, 52 patients had normal cognitive function, 33 had MCI, and 27 had dementia. The area under the receiver operating curve for the M-ACE was 0.96 (95% CI 0.95-1.00). The sensitivity and specificity for a dementia diagnosis were 0.96 and 0.84 at the cut point <25 and 0.70 and 1.00 at the cut point <21. Mean M-ACE scores differed significantly between normal, demented, and MCI groups ( < 0.001), and compared to the MMSE, the M-ACE did not suffer from ceiling effects.
The M-ACE is an easily administered test with good sensitivity and specificity to capture and assist in the diagnosis of MCI or dementia in patients with CKD and diabetes.
背景/目的：我们在一组患有慢性肾脏病（CKD）和糖尿病的老年人中测试了简易版Addenbrooke认知检查（M-ACE）的效用。
对112名到肾脏病门诊就诊的CKD和糖尿病患者进行M-ACE检查。认知障碍基于患者、 informant以及病例回顾、神经心理学评估，以及轻度认知障碍（MCI）标准和《精神疾病诊断与统计手册》第五版中痴呆症标准的应用。还将M-ACE与简易精神状态检查表（MMSE）进行了比较。
经评估，52名患者认知功能正常，33名有MCI，27名有痴呆症。M-ACE的受试者工作特征曲线下面积为0.96（95%置信区间0.95 - 1.00）。痴呆症诊断的敏感性和特异性在切点<25时分别为0.96和0.84，在切点<21时分别为0.70和1.0。正常、痴呆和MCI组之间的M-ACE平均得分差异显著（<0.001），并且与MMSE相比，M-ACE不存在天花板效应。
M-ACE是一种易于实施的测试，对CKD和糖尿病患者中MCI或痴呆症的捕捉和辅助诊断具有良好的敏感性和特异性。
