Department of Neurology, Mayo Clinic, Rochester, MN.
Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2019 Aug;94(8):1516-1523. doi: 10.1016/j.mayocp.2019.01.043. Epub 2019 Jul 4.
To compare the Short Test of Mental Status (STMS) with the Montreal Cognitive Assessment (MoCA) for predicting and detecting mild cognitive impairment (MCI).
Participants from the community-based Mayo Clinic Study of Aging (MCSA) (November 24, 2010, through May 19, 2012) and an academic referral Alzheimer's Disease Research Center (ADRC) (March 16, 2015, through September 5, 2018) were analyzed. All participants were evaluated using a standardized neuropsychological battery, and a multidisciplinary consensus diagnosis was assigned. The MCSA and ADRC samples included 313 and 106 stable cognitively normal (CN) participants, 72 and 8 CN participants at baseline who developed incident MCI or dementia, 114 and 96 participants with prevalent MCI, and 25 and 132 participants with dementia, respectively.
There were no statistically significant differences between the 2 tests in 6 of 7 diagnostic comparisons across academic referral and community populations. The STMS had a better area under the curve (0.90; 95% CI, 0.87-0.93) for differentiating prevalent MCI from CN participants in the MCSA cohort compared with the MoCA cohort (0.85; 95% CI, 0.81-0.89; P=.01). In addition, 53% of the stable CN participants (222 of 419) scored less than 26 on the MoCA, with specificity of 47% for diagnosing prevalent MCI.
We provide evidence that the STMS performs similarly to the MoCA in a variety of settings and neurodegenerative syndromes. These results suggest that the current recommended MoCA cutoff score may be overly sensitive, consistent with previous studies. We also provide a conversion table for comparing the 2 cognitive tests.
比较简易精神状态检查（STMS）和蒙特利尔认知评估（MoCA），以预测和检测轻度认知障碍（MCI）。
分析了来自基于社区的梅奥诊所老龄化研究（MCSA）（2010 年 11 月 24 日至 2012 年 5 月 19 日）和学术转诊阿尔茨海默病研究中心（ADRC）（2015 年 3 月 16 日至 2018 年 9 月 5 日）的社区参与者。所有参与者均使用标准化神经心理学测试进行评估，并进行了多学科共识诊断。MCSA 和 ADRC 样本分别包括 313 名和 106 名稳定认知正常（CN）参与者、72 名和 8 名基线时发生 MCI 或痴呆的 CN 参与者、114 名和 96 名患有常见 MCI 的参与者以及 25 名和 132 名患有痴呆症的参与者。
在学术转诊和社区人群的 7 项诊断比较中，有 6 项比较中，这两种测试之间没有统计学上的显著差异。与 MCSA 队列中的 MoCA 相比，STMS 用于区分 MCSA 队列中常见的 MCI 与 CN 参与者的曲线下面积（AUC）更好（0.90；95%CI，0.87-0.93），而 MoCA 为 0.85（95%CI，0.81-0.89；P=.01）。此外，在 MCSA 队列中，53%的稳定 CN 参与者（222/419）的 MoCA 得分低于 26，其对常见 MCI 的诊断特异性为 47%。
我们提供的证据表明，在各种环境和神经退行性综合征中，STMS 的表现与 MoCA 相似。这些结果表明，目前推荐的 MoCA 截断值可能过于敏感，这与之前的研究一致。我们还提供了一个比较这两种认知测试的转换表。
