基层医疗中的认知筛查测试：低教育水平的切点
Cognitive screening test in primary care: cut points for low education.
作者信息
Yokomizo Juliana Emy, Seeher Katrin, Oliveira Glaucia Martins de, Silva Laís Dos Santos Vinholi E, Saran Laura, Brodaty Henry, Aprahamian Ivan, Yassuda Monica Sanches, Bottino Cássio Machado de Campos
机构信息
Universidade de São Paulo. Faculdade de Medicina. Programa Terceira Idade (PROTER), Instituto de Psiquiatria. São Paulo, SP, Brasil.
University of New South Wales. Dementia Collaborative Research Center. Sydney, New South Wales, Australia.
出版信息
Rev Saude Publica. 2018 Nov 23;52:88. doi: 10.11606/S1518-8787.2018052000462.
OBJECTIVE
To establish the diagnostic accuracy of the Brazilian version of the General Practitioner Assessment of Cognition (GPCOG-Br) compared to the Mini-Mental State Examination (MMSE) in individuals with low educational level.
METHODS
Ninety-three patients (≥ 60 years old) from Brazilian primary care units provided sociodemographic, cognitive, and functional data. Receiver operating characteristics, areas under the curve (AUC) and logistic regressions were conducted.
RESULTS
Sixty-eight patients with 0-4 years of education. Cases (n = 44) were older (p = 0.006) and performed worse than controls (n = 49) on all cognitive or functional measures (p < 0.001). The GPCOG-Br demonstrated similar diagnostic accuracy to the MMSE (AUC = 0.90 and 0.91, respectively) and similar positive and negative predictive values (PPV/NPV, respectively: 0.79/0.86 for GPCOG-Br and 0.79/0.81 for MMSE). Adjusted cut-points displayed high sensitivity (all 86%) and satisfactory specificity (65%-80%). Lower educational level predicted lower cognitive performance.
CONCLUSIONS
The GPCOG-Br is clinically well-suited for use in primary care.
目的
比较巴西版全科医生认知评估量表（GPCOG-Br）与简易精神状态检查表（MMSE）在低教育水平个体中的诊断准确性。
方法
来自巴西基层医疗单位的93名患者（≥60岁）提供了社会人口学、认知和功能数据。进行了受试者工作特征分析、曲线下面积（AUC）分析和逻辑回归分析。
结果
68名患者接受过0-4年教育。病例组（n = 44）年龄更大（p = 0.006），在所有认知或功能测量方面的表现均比对照组（n = 49）差（p < 0.001）。GPCOG-Br显示出与MMSE相似的诊断准确性（AUC分别为0.90和0.91），以及相似的阳性和阴性预测值（PPV/NPV，GPCOG-Br分别为0.79/0.86，MMSE分别为0.79/0.81）。调整后的切点显示出高敏感性（均为86%）和令人满意的特异性（65%-80%）。较低的教育水平预示着较低的认知表现。
结论
GPCOG-Br在临床应用中非常适合基层医疗。
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