Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
J Alzheimers Dis. 2020;73(3):981-990. doi: 10.3233/JAD-190982.
Early detection of cognitive decline allows timely intervention to delay progression of dementia. However, current cognitive evaluation tools often include items delivered via verbal forms of instruction, which can cause poor performance in patients with hearing loss.
To develop and validate a cognitive screening battery, the Reading Cognitive Test Kyoto (ReaCT Kyoto), comprising test items given through non-verbal instruction.
A cross-sectional and multi-center study was conducted in the three medical institutes. ReaCT Kyoto was designed to evaluate domains of "registration," "repetition," "delayed recall," "visuospatial recognition," "orientation in time and place," and "executive function." The Japanese version of the Mini-Mental State Examination Test (MMSE-J) and ReaCT Kyoto were applied by experienced psychotherapists. Concurrent validity was evaluated between the ReaCT Kyoto Test and MMSE-J and between the ReaCT Kyoto Test and physician-diagnosed dementia.
ReaCT Kyoto was validated in a sample of 115 participants. The mean age of subjects was 81.0±6.4 years, and the sample comprised 53.0% females. The area under the receiver operating curves was 0.95 for detecting physician-diagnosed dementia. When classifying patients in accordance with presence or absence of hearing loss, the AUCs were 0.93 and 0.97 for those with and without hearing loss, respectively. With a cut-off score of < 29 points for suspected dementia, ReaCT Kyoto correctly classified 90.4% of the subjects as belonging to the group with or without physician-diagnosed dementia.
ReaCT Kyoto provides an appropriate solution for detection of cognitive impairment in persons with or without hearing loss.
早期发现认知能力下降可及时干预以延缓痴呆进展。然而，目前的认知评估工具通常包括通过口头形式的指令来完成的项目，这可能导致听力损失患者表现不佳。
开发和验证认知筛查工具，即京都阅读认知测试（ReaCT Kyoto），包含通过非言语指令提供的测试项目。
在三个医学研究所进行了一项横断面和多中心研究。ReaCT Kyoto 旨在评估“登记”、“重复”、“延迟回忆”、“视觉空间识别”、“时间和地点定向”和“执行功能”等领域。经验丰富的心理治疗师应用日本版简易精神状态检查（MMSE-J）和 ReaCT Kyoto。评估了 ReaCT Kyoto 测试与 MMSE-J 之间以及 ReaCT Kyoto 测试与医生诊断的痴呆之间的同时效度。
在 115 名参与者中验证了 ReaCT Kyoto。受试者的平均年龄为 81.0±6.4 岁，样本中 53.0%为女性。用于检测医生诊断的痴呆的受试者工作特征曲线下面积为 0.95。当根据听力损失的存在与否对患者进行分类时，无听力损失和有听力损失患者的 AUC 分别为 0.93 和 0.97。当以<29 分作为疑似痴呆的截断值时，ReaCT Kyoto 正确分类了 90.4%的受试者属于有或无医生诊断的痴呆组。
ReaCT Kyoto 为听力损失或无听力损失者的认知障碍检测提供了一个合适的解决方案。
