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评估台湾临床实践中帕金森病患者的轻度认知功能障碍。

Evaluating Mild Cognitive Dysfunction in Patients with Parkinson's Disease in Clinical Practice in Taiwan.

机构信息

Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Sci Rep. 2020 Jan 23;10(1):1014. doi: 10.1038/s41598-020-58042-2.

Abstract

Our study aimed to examine the contribution of commonly used tools, including the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), and develop a formula for conversion of these tests in the Chinese population. We also create a predictive model for the detection of Chinese patients' mild cognitive impairment (MCI). We recruited 168 patients with Parkinson's disease (PD) from 12 medical centres or teaching hospitals in Taiwan, and each participant received a comprehensive neuropsychological assessment. Logistic regression analysis was conducted to find predictors of MCI with the help of a generalized additive model. We found that patients with an MMSE > 25 or a MoCA > 21 were less likely to have MCI. The discrimination powers of the two tests used for detecting MCI were 0.902 and 0.868, respectively, as measured by the area under the receiver operating characteristic curve (ROC). The best predictive model suggested that patients with a higher MMSE score, delayed recall scores of the 12-item Word Recall Test ≥ 5.817, and no test decline in the visuospatial index were less likely to have MCI (ROC = 0.982). Our findings have clinical utility in MCI detection in Chinese PD and need a larger sample to confirm.

摘要

我们的研究旨在检验常用工具(包括简易精神状态检查(MMSE)和蒙特利尔认知评估(MoCA))的贡献,并制定一个适用于中国人的这些测试的转换公式。我们还创建了一个用于检测中国患者轻度认知障碍(MCI)的预测模型。我们从台湾的 12 家医疗中心或教学医院招募了 168 名帕金森病(PD)患者,每位参与者都接受了全面的神经心理学评估。借助广义加性模型进行逻辑回归分析,以找到 MCI 的预测指标。我们发现 MMSE>25 或 MoCA>21 的患者不太可能患有 MCI。这两种测试用于检测 MCI 的判别能力分别为 0.902 和 0.868,这是通过接受者操作特征曲线(ROC)下的面积来衡量的。最佳预测模型表明,MMSE 评分较高、12 项单词回忆测验延迟回忆得分≥5.817 且视空间指数无测试下降的患者不太可能患有 MCI(ROC=0.982)。我们的研究结果对中国 PD 患者的 MCI 检测具有临床实用价值,需要更大的样本量来证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c451/6978523/0c5401f016c1/41598_2020_58042_Fig1_HTML.jpg

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