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中文版圣路易斯大学精神状态检查(SLUMS)检测颅脑损伤患者认知障碍的效度和信度的初步研究。

Preliminary study of the validity and reliability of the Chinese version of the Saint Louis University Mental Status Examination (SLUMS) in detecting cognitive impairment in patients with traumatic brain injury.

机构信息

Department of Rehabilitation Medicine, The First People's Hospital of Changzhou, Changzhou, China.

Department of Rehabilitation Medicine, School of Clinical Medicine, Soochow University, Suzhou, China.

出版信息

Appl Neuropsychol Adult. 2021 Nov-Dec;28(6):633-640. doi: 10.1080/23279095.2019.1680986. Epub 2019 Oct 24.

Abstract

The Saint Louis University Mental Status Examination (SLUMS) has been shown to be useful in the cognitive assessment in older adults and patients with dementia. The aim of this study was to preliminarily explore the effectiveness of the Chinese version of the SLUMS in the detection of cognitive impairment in patients with traumatic brain injury (TBI) and to provide an objective basis for its clinical application in China. In this cross-sectional study, 42 patients with TBI and 30 matched normal controls were administered. Participants were assessed by the Chinese version of the Mini-Mental State Assessment scale (MMSE), Montreal Cognitive Assessment scale (MoCA) and SLUMS. Results showed that the Chinese version of the SLUMS had satisfactory internal consistency (Cronbach's α coefficient: 0.723), excellent interrater reliability (ICC: 0.990-0.998) and intrarater reliability (ICC: 0.968), as well as good validity. In the TBI group, the total SLUMS score was moderately positively correlated with the MMSE score ( = 0.702,  = .000) and highly positively correlated with the MoCA score ( = 0.831,  = .000). Receiver Operating Characteristic (ROC) curve analyses showed that the area under the curve (AUC) of the SLUMS, MMSE and MoCA were 0.872, 0.756 and 0.916, respectively. The optimal cutoff score of 22.5 or fewer points are suggested for the SLUMS to discriminate cognitive impairment, with a sensitivity of 0.844 and a specificity of 0.825. The Chinese version of the SLUMS has excellent reliability and validity, and can be used as a screening tool for cognitive impairment of patients with TBI in China.

摘要

圣路易斯大学精神状态检查(SLUMS)已被证明在老年人群体和痴呆患者的认知评估中非常有用。本研究旨在初步探讨中文版 SLUMS 检测创伤性脑损伤(TBI)患者认知障碍的有效性,并为其在中国的临床应用提供客观依据。在这项横断面研究中,对 42 名 TBI 患者和 30 名匹配的正常对照进行了评估。参与者接受了中文版简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)和 SLUMS 的评估。结果表明,中文版 SLUMS 具有令人满意的内部一致性(Cronbach's α 系数:0.723)、优异的评分者间信度(ICC:0.990-0.998)和评分者内信度(ICC:0.968),以及良好的效度。在 TBI 组中,SLUMS 总分与 MMSE 评分呈中度正相关(r=0.702,P=0.000),与 MoCA 评分呈高度正相关(r=0.831,P=0.000)。受试者工作特征(ROC)曲线分析显示,SLUMS、MMSE 和 MoCA 的曲线下面积(AUC)分别为 0.872、0.756 和 0.916。建议将 SLUMS 的 22.5 分或以下的得分作为区分认知障碍的最佳截断值,其灵敏度为 0.844,特异性为 0.825。中文版 SLUMS 具有良好的信度和效度,可作为中国 TBI 患者认知障碍的筛查工具。

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