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中文版简易认知评估量表用于筛查轻度认知障碍和轻度痴呆的验证研究。

A Validation Study of the Chinese Version of the Mini-Addenbrooke's Cognitive Examination for Screening Mild Cognitive Impairment and Mild Dementia.

机构信息

1 Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.

2 Department of Neurology, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.

出版信息

J Geriatr Psychiatry Neurol. 2019 Jul;32(4):205-210. doi: 10.1177/0891988719841726. Epub 2019 Apr 15.

Abstract

BACKGROUND/AIMS: There are limited cognitive screening tests for the Chinese-speaking population. This study aimed to validate the Chinese version of the Mini-Addenbrooke's Cognitive Examination (M-ACE) for detecting mild cognitive impairment (MCI) and mild dementia. Its diagnostic accuracy was compared with that of Mini-Mental State Examination (MMSE). The study also evaluated the influential factors of M-ACE scores and its convergent validity against Clinical Dementia Rating Scale (CDR) and MMSE.

METHOD

One hundred sixty-nine participants were classified into 3 groups: mild dementia, MCI, and healthy control. Mini-Mental State Examination and M-ACE were administered by researchers who were blinded to the clinical grouping. Receiver operating characteristic curves were graphed to test the diagnostic accuracy.

RESULTS

Mini-Addenbrooke's Cognitive Examination scores had good convergent validity against CDR and MMSE. Years of education ( r = 0.4, P < .001) yielded significant impacts on M-ACE scores. The optimal cutoff score of M-ACE to detect MCI was 25/26 (sensitivity = 0.88; specificity = 0.72) with an area under curve (AUC) significantly higher than MMSE (0.86 vs 0.72). The optimal cutoff score of M-ACE to screen mild dementia (21/22) yielded satisfactory sensitivity (0.96) and specificity (0.87) with a comparable AUC to MMSE (0.96 vs 0.94).

CONCLUSIONS

Mini-Addenbrooke's Cognitive Examination was a brief and reliable tool to detect MCI and mild dementia in the Chinese-speaking population significantly superior to MMSE when detecting MCI.

摘要

背景/目的:针对中文使用者的认知筛选测试有限。本研究旨在验证简易型认知评估量表(Mini-Addenbrooke's Cognitive Examination,M-ACE)中文版用于检测轻度认知障碍(mild cognitive impairment,MCI)和轻度痴呆的能力。并比较其与简易精神状态检查(Mini-Mental State Examination,MMSE)的诊断准确性。该研究还评估了 M-ACE 评分的影响因素及其与临床痴呆评定量表(Clinical Dementia Rating Scale,CDR)和 MMSE 的收敛效度。

方法

169 名参与者被分为 3 组:轻度痴呆、MCI 和健康对照组。由对临床分组不知情的研究人员进行简易精神状态检查和 M-ACE 测试。绘制受试者工作特征曲线以测试诊断准确性。

结果

M-ACE 评分与 CDR 和 MMSE 具有良好的收敛效度。受教育年限(r = 0.4,P <.001)对 M-ACE 评分有显著影响。M-ACE 检测 MCI 的最佳截断值为 25/26(灵敏度 = 0.88;特异性 = 0.72),曲线下面积(area under the curve,AUC)显著高于 MMSE(0.86 vs 0.72)。M-ACE 筛查轻度痴呆的最佳截断值(21/22)具有较高的灵敏度(0.96)和特异性(0.87),与 MMSE 的 AUC 相当(0.96 vs 0.94)。

结论

简易型认知评估量表是一种用于检测中文使用者 MCI 和轻度痴呆的简短且可靠的工具,在检测 MCI 方面明显优于 MMSE。

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