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评估帕金森病患者认知筛查措施的敏感性和特异性。

Assessing the sensitivity and specificity of cognitive screening measures for people with Parkinson's disease.

作者信息

Foley T, McKinlay A, Warren N, Stolwyk R J

机构信息

School of Psychological Sciences, Monash University, VIC, Australia.

Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia.

出版信息

NeuroRehabilitation. 2018;43(4):491-500. doi: 10.3233/NRE-182433.

Abstract

INTRODUCTION

While cognitive impairment is a recognised feature of Parkinson's disease (PD), few studies have evaluated the validity of brief cognitive screening measures compared to a comprehensive neuropsychological assessment. This studies aim was to evaluate the sensitivity and specificity of the Mini-Mental State Examination (MMSE), Modified Mini-Mental State Examination and Dementia Rating Scale (DRS-2) to detect cognitive impairment in individuals with PD.

METHOD

Fifty-eight participants were administered the MMSE, 3MS, DRS-2 and a neuropsychological battery. ROC analyses were conducted to assess their effectiveness in classifying cognitive impairment.

RESULTS

None of the three measures demonstrated good sensitivity or specificity to detect single domain cognitive impairment. For detecting impairment on two or more cognitive domains, the MMSE and DRS-2 yielded excellent sensitivity (88%) and specificity (78% and 76% respectively), at cut-off scores of 28 and 136 respectively. The 3MS demonstrated excellent sensitivity (88%) and good specificity (60%) at cut off score of 94.

CONCLUSION

The MMSE and DRS-2 have excellent discriminant ability to classify multi-domain cognitive impairment in PD, however, their ability to detect more focal cognitive impairment is limited. Given that focal domain may be an indicator that could be useful in early detection of cognitive impairment for people with PD, this finding has implication for the use of these measures as screening tools in clinical practice.

摘要

引言

虽然认知障碍是帕金森病(PD)的一个公认特征,但与全面的神经心理学评估相比,很少有研究评估简短认知筛查措施的有效性。本研究的目的是评估简易精神状态检查表(MMSE)、改良简易精神状态检查表和痴呆评定量表(DRS-2)检测帕金森病患者认知障碍的敏感性和特异性。

方法

对58名参与者进行了MMSE、3MS、DRS-2和一套神经心理测试。进行ROC分析以评估它们在分类认知障碍方面的有效性。

结果

这三种测量方法均未显示出检测单一领域认知障碍的良好敏感性或特异性。对于检测两个或更多认知领域的损伤,MMSE和DRS-2分别在临界值为28和136时具有出色的敏感性(88%)和特异性(分别为78%和76%)。3MS在临界值为94时表现出出色的敏感性(88%)和良好的特异性(60%)。

结论

MMSE和DRS-2在分类帕金森病多领域认知障碍方面具有出色的判别能力,然而,它们检测更局灶性认知障碍的能力有限。鉴于局灶性领域可能是帕金森病患者早期认知障碍检测的一个有用指标,这一发现对这些测量方法在临床实践中作为筛查工具的使用具有启示意义。

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