Medical School, Medical Sciences Division, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
Int J Geriatr Psychiatry. 2019 Feb;34(2):233-242. doi: 10.1002/gps.5016. Epub 2018 Nov 27.
Mild cognitive impairment (MCI) is regarded as a prodrome to dementia. Various cognitive tests can help with diagnosis; meta-analysis of diagnostic accuracy studies would assist clinicians in choosing optimal tests.
We searched online databases for "mild cognitive impairment" and "diagnosis" or "screening" from 01/01/1999 to 01/07/2017. Articles assessing the diagnostic accuracy of a cognitive test compared with standard diagnostic criteria were extracted. Risk of bias was assessed. Bivariate random-effects meta-analysis was used to evaluate sensitivity and specificity.
Eight cognitive tests (ACE-R, CERAD, CDT-Sunderland, IQCODE, Memory Alteration Test, MMSE, MoCA, and Qmci) were considered for meta-analysis. ACE-R, CERAD, MoCA, and Qmci were found to have similar diagnostic accuracy, while the MMSE had lower sensitivity. Memory Alteration Test had the highest sensitivity and equivalent specificity to the other tests.
Multiple cognitive tests have comparable diagnostic accuracy. The Memory Alteration Test is short and has the highest sensitivity. New cognitive tests for MCI diagnosis should not be compared with the MMSE.
轻度认知障碍（MCI）被认为是痴呆的前兆。各种认知测试有助于诊断；对诊断准确性研究的荟萃分析将帮助临床医生选择最佳测试。
我们从 1999 年 1 月 1 日至 2017 年 7 月 1 日在在线数据库中搜索了“轻度认知障碍”和“诊断”或“筛查”。提取了评估认知测试与标准诊断标准相比的诊断准确性的文章。评估偏倚风险。使用双变量随机效应荟萃分析评估敏感性和特异性。
有 8 种认知测试（ACE-R、CERAD、CDT-桑德兰、IQCODE、Memory Alteration Test、MMSE、MoCA 和 Qmci）被认为可进行荟萃分析。ACE-R、CERAD、MoCA 和 Qmci 的诊断准确性相似，而 MMSE 的敏感性较低。Memory Alteration Test 具有最高的敏感性，且特异性与其他测试相当。
多种认知测试具有相当的诊断准确性。Memory Alteration Test 较短，具有最高的敏感性。新的 MCI 诊断认知测试不应与 MMSE 进行比较。
