Carnero-Pardo C, Rego-García I, Barrios-López J M, Blanco-Madera S, Calle-Calle R, López-Alcalde S, Vílchez-Carrillo R M
FIDYAN Neurocenter, Granada, España.
Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, España.
Neurologia (Engl Ed). 2022 Jan-Feb;37(1):13-20. doi: 10.1016/j.nrl.2018.12.002. Epub 2019 Mar 5.
The Mini-Cog is a very brief, widely used cognitive test that includes a memory task and a simplified assessment of the Clock Drawing Test (CDT). There is not a formal evaluation of the Mini-Cog test in Spanish. This study aims to analyse the diagnostic usefulness of the Mini-Cog and CDT for detecting cognitive impairment (CI).
We performed a cross-sectional study, systematically including all patients who consulted at our neurology clinic over a 6-month period. We assessed diagnostic usefulness for detecting CI (defined according to the National Institute on Aging-Alzheimer's Association criteria for mild cognitive impairment and dementia) according to the area under the receiver operating characteristic curve (AUC). Sensitivity, specificity, and positive and negative likelihood ratios were calculated for each cut-off point.
The study included 581 individuals (315 with CI); 55.1% were women and 27.7% had not completed primary studies. The Mini-Cog showed greater diagnostic usefulness than the CDT (AUC±sensitivity: 0.88±0.01 vs 0.84±0.01; P<.01). Both instruments were less useful for screening in individuals with a low education level (0.74±0.05 vs 0.75±0.05, respectively). A cut-off point of 2/3 in the Mini-Cog achieved a sensitivity of 0.90 (95%CI, 0.87-0.93) and a specificity of 0.71 (95%CI, 0.65-0.76); a cut-off point of 5/6 in the CDT achieved a sensitivity of 0.77 (95%CI, 0.72-0.81) and a specificity of 0.80 (95%CI, 0.75-0.85).
In our neurology clinic, the Mini-Cog showed acceptable diagnostic usefulness for detecting CI, greater than that of the CDT; neither test is an appropriate instrument for individuals with a low level of education.
简易认知筛查量表（Mini-Cog）是一种非常简短且广泛使用的认知测试，它包括一个记忆任务和对画钟试验（CDT）的简化评估。目前尚无针对西班牙语版Mini-Cog测试的正式评估。本研究旨在分析Mini-Cog和CDT在检测认知障碍（CI）方面的诊断效用。
我们进行了一项横断面研究，系统纳入了在6个月期间到我们神经科门诊就诊的所有患者。我们根据受试者工作特征曲线（AUC）下的面积评估检测CI（根据美国国立衰老研究所-阿尔茨海默病协会轻度认知障碍和痴呆标准定义）的诊断效用。计算每个切点的敏感性、特异性以及阳性和阴性似然比。
该研究纳入了581名个体（315名患有CI）；55.1%为女性，27.7%未完成小学学业。Mini-Cog显示出比CDT更高的诊断效用（AUC±敏感性：0.88±0.01对0.84±0.01；P<0.01）。两种工具对低教育水平个体的筛查效用均较低（分别为0.74±0.05和0.75±0.05）。Mini-Cog中2/3的切点敏感性为0.90（95%CI，0.87 - 0.93），特异性为0.71（95%CI，0.65 - 0.76）；CDT中5/6的切点敏感性为0.77（95%CI，0.72 - 0.81），特异性为0.80（95%CI，0.75 - 0.85）。
在我们的神经科门诊，Mini-Cog在检测CI方面显示出可接受的诊断效用，高于CDT；这两种测试都不适用于低教育水平的个体。
