Scheffels Jannik Florian, Fröhlich Leon, Kalbe Elke, Kessler Josef
Clinic and Polyclinic for Neurology, University Hospital Cologne, University of Cologne, Cologne, Germany.
Cologne University of Applied Sciences, faculty: Economics and Law, Cologne, Germany.
J Neurol Sci. 2020 May 15;412:116735. doi: 10.1016/j.jns.2020.116735. Epub 2020 Feb 13.
Cognitive impairment (CI) is frequently observed in Parkinson's disease (PD) and negatively influences the patient's and carer's quality of life. As a first step, assessment of CI is often accomplished by using screening instruments (level I diagnosis). Three commonly used instruments are the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Parkinson Neuropsychometric Dementia Assessment (PANDA). Because different preferences regarding test selection exist between clinics, this study aims to provide evidence about the concordance of these tests. It also converts total test scores of the three instruments to assist clinical practice.
Between January and December 2018, 96 patients with idiopathic PD were examined at the University Hospital of Cologne, Germany. Comparability of MMSE, MoCA, and PANDA scores was investigated by calculating correlations, classification agreements, and percentile ranks. Additionally, we converted test scores among the three screening instruments by implementing the equipercentile equating method and log-linear smoothing.
The MMSE classified 26%, the PANDA 32.3% and the MoCA 54.2% of PD patients as having CI. The screening instruments' concordance in classifying cognition into normal cognition versus CI was 75% (AC1 = 0.62) for MMSE and PANDA, 63.5% (AC1 = 0.28) for MoCA and PANDA, and 57.3% (AC1 = 0.24) for MMSE and MoCA. The provided conversion table enables a quick and easy transformation of the three screening instruments within PD diagnostics.
These results contribute to a better understanding of the screenings' utility and concordance in a population of PD patients. Additionally, communication between clinics may be enhanced.
认知障碍（CI）在帕金森病（PD）中很常见，会对患者及其照料者的生活质量产生负面影响。作为第一步，CI的评估通常通过使用筛查工具来完成（一级诊断）。三种常用的工具是简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）和帕金森神经心理痴呆评估量表（PANDA）。由于不同诊所对测试选择存在不同偏好，本研究旨在提供这些测试一致性的证据。它还对这三种工具的总分进行转换，以辅助临床实践。
2018年1月至12月期间，德国科隆大学医院对96例特发性PD患者进行了检查。通过计算相关性、分类一致性和百分位数排名，研究了MMSE、MoCA和PANDA评分的可比性。此外，我们通过实施等百分位等值法和对数线性平滑法，在三种筛查工具之间转换测试分数。
MMSE将26%的PD患者归类为有CI，PANDA为32.3%，MoCA为54.2%。在将认知分为正常认知与CI方面，MMSE和PANDA的筛查工具一致性为75%（AC1 = 0.62），MoCA和PANDA为63.5%（AC1 = 0.28），MMSE和MoCA为57.3%（AC1 = 0.24）。提供的转换表能够在PD诊断中快速简便地转换这三种筛查工具。
这些结果有助于更好地理解在PD患者群体中筛查工具的效用和一致性。此外，还可以加强不同诊所之间的沟通。
