Love Marissa C Natelson, Pilonieta Giovanna, Geldmacher David S
Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Neurology, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA.
Prim Care Companion CNS Disord. 2019 Mar 14;21(2):18m02336. doi: 10.4088/PCC.18m02336.
We assessed the clinical utility of the Alabama Brief Cognitive Screener (ABCs), an alternative to the Mini-Mental State Examination (MMSE), for cognitive screening in a new electronic medical record. Other available nonproprietary instruments were determined to be more tuned to milder deficits than the MMSE.
The ABCs was administered as part of routine clinical assessment in the University of Alabama at Birmingham memory disorders clinics from April 30, 2012, to April 30, 2015. Outpatients (N = 1,589) with clinician diagnoses (ICD-9-CM) of memory loss, mild cognitive impairment, neurodegenerative cognitive impairment, Alzheimer's dementia, or dementia not otherwise specified were included in the analysis. Memory disorder clinicians used multiple sources of information for assignment of diagnoses, including interviews with patients and caregivers, the ABCs, figure copy, semantic fluencies, phonemic fluencies, ratings of daily function, imaging, laboratory tests, and medical records.
Scoring distribution by diagnosis was mild cognitive impairment (n = 310): mean (SD) = 25.47 (3.37), median = 26; Alzheimer's dementia (n = 208): mean (SD) = 16.42 (6.33), median = 17; cerebral degeneration (n = 371): mean (SD) = 20.61 (5.90), median = 21; memory loss (n = 583): mean (SD) = 24.90 (5.09), median = 27; and dementia (n = 117): mean (SD) = 15.18 (6.34), median = 15. Mean ABCs scores differed by diagnosis (Wilcoxon signed-ranks Z = 483.5, P < .001). This finding was consistent with a meta-analysis of MMSE performance between groups.
ABCs scores vary appropriately by diagnosis and resemble MMSE scoring distributions. The ABCs provides a nonproprietary alternative to the MMSE to assess the severity of cognitive deficits.
我们评估了阿拉巴马简易认知筛查量表（ABCs）在新电子病历中用于认知筛查的临床效用，该量表可替代简易精神状态检查表（MMSE）。已确定其他现有的非专利工具比MMSE更适合检测较轻的认知缺陷。
2012年4月30日至2015年4月30日期间，在阿拉巴马大学伯明翰分校记忆障碍诊所，ABCs作为常规临床评估的一部分进行施测。分析纳入了门诊患者（N = 1589例），这些患者经临床医生诊断（ICD-9-CM）患有失忆、轻度认知障碍、神经退行性认知障碍、阿尔茨海默病性痴呆或未另作说明的痴呆。记忆障碍临床医生使用多种信息来源进行诊断，包括与患者及照料者的访谈、ABCs、图形临摹、语义流畅性、语音流畅性、日常功能评分、影像学检查、实验室检查和病历。
按诊断分类的得分分布为：轻度认知障碍（n = 310）：均值（标准差）= 25.47（3.37），中位数 = 26；阿尔茨海默病性痴呆（n = 208）：均值（标准差）= 16.42（6.33），中位数 = 17；脑变性（n = 371）：均值（标准差）= 20.61（5.90），中位数 = 21；失忆（n = 583）：均值（标准差）= 24.90（5.09），中位数 = 27；痴呆（n = 117）：均值（标准差）= 15.18（6.34），中位数 = 15。ABCs的平均得分因诊断而异（Wilcoxon符号秩和检验Z = 483.5，P < .001）。这一发现与不同组间MMSE表现的荟萃分析结果一致。
ABCs得分根据诊断情况有适当差异，且与MMSE得分分布相似。ABCs为评估认知缺陷的严重程度提供了一种非专利的MMSE替代方法。
