Danish Dementia Research Centre, Department of Neurology, University of Copenhagen, Copenhagen, Denmark.
Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Int J Geriatr Psychiatry. 2019 Nov;34(11):1724-1733. doi: 10.1002/gps.5188. Epub 2019 Aug 19.
The aim of this study was to develop and validate a new brief and accurate case-finding instrument for dementia and cognitive impairment. Previous research indicates that combining cognitive tests with informant and/or patient report may improve accuracy in dementia case-finding. The Brief Assessment of Impaired Cognition (BASIC) integrates these three sources of information.
BASIC was prospectively validated in five memory clinics. Patients consecutively referred from general practice were tested at their initial visit prior to diagnosis. Control participants were primarily recruited among participating patients' relatives. Expert clinical diagnosis was subsequently used as gold standard for estimation of the classification accuracy of BASIC.
A very high discriminative validity (specificity 0.98, sensitivity 0.95) for dementia (n = 122) versus socio-demographically matched control participants (n = 109) was found. In comparison, the MMSE had 0.90 specificity and 0.82 sensitivity. Extending the discriminative validity analysis to cognitive impairment (both dementia and MCI, n = 162) only slightly reduced the discriminative validity of BASIC whereas the discriminative validity of the MMSE was substantially attenuated. Administration time for BASIC was approximately 5 minutes compared with 10 to 15 minutes for the MMSE.
BASIC was found to be an efficient and valid case-finding instrument for dementia and cognitive impairment in a memory clinic setting.
本研究旨在开发和验证一种新的、简短而准确的痴呆症和认知障碍病例发现工具。先前的研究表明，将认知测试与知情者和/或患者报告相结合，可能会提高痴呆症病例发现的准确性。简短认知评估工具（BASIC）整合了这三种信息来源。
BASIC 在五个记忆诊所进行了前瞻性验证。从普通诊所连续转诊的患者在首次就诊前进行测试，以便在诊断前进行测试。对照参与者主要从参与患者的亲属中招募。随后，将专家临床诊断用作 BASIC 分类准确性的金标准。
痴呆症（n = 122）与社会人口统计学匹配的对照组参与者（n = 109）之间发现了非常高的判别有效性（特异性 0.98，敏感性 0.95）。相比之下，MMSE 的特异性为 0.90，敏感性为 0.82。将判别有效性分析扩展到认知障碍（包括痴呆症和 MCI，n = 162），仅略微降低了 BASIC 的判别有效性，而 MMSE 的判别有效性则大大降低。BASIC 的管理时间约为 5 分钟，而 MMSE 的管理时间为 10 到 15 分钟。
在记忆诊所环境中，BASIC 被发现是一种有效且有效的痴呆症和认知障碍病例发现工具。
