Departments of Neurology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Faculty of Nursing and Medical Care Graduate School of Health Management, Keio University, Kanagawa, Japan.
PLoS One. 2020 May 14;15(5):e0233225. doi: 10.1371/journal.pone.0233225. eCollection 2020.
As the population of patients with cognitive decline grows, physicians and caregivers need brief screening tools. Comprehensive neurocognitive batteries require special training and time for evaluation. We focused on accessibility and compared the diagnostic power of several easy questions.
"Attended With" (AW) and "Head-Turning Sign" (HTS) factors and participants' replies to following questions were recorded: "Do you feel that you have more difficulties in your daily life than you used to?", [no consciousness (C-) or consciousness+ (C+)], "Could you tell me about your daily pleasures or pastimes?" [no pleasure (P-) or pleasure + (P+)], "What are notable current/recent news/topics?" [no news (N-) or news+ (N+)].
This took place in our Memory Clinic between May 2016 and July 2019.
We enrolled 162 consecutive cases (44 cognitive normal (CN), 55 amnestic mild cognitive impairment (aMCI), and 48 Alzheimer's disease (AD)).
The sensitivity and specificity of each battery were calculated, and on account of those numbers, the population attributable risk percent % (PAR%) of (AW and HTS+), (C- and P-), (C- and N-), (P- and N-) as analysis of combination of questions, respectively, were calculated.
AW had high sensitivity, 87.4, 95.8% (CN vs aMCI + AD, CN + aMCI vs AD) but the sensitivity of HTS was only 46.4, 57.7%, and HTS showed high specificity, 100.0, 71.8%. C- had high sensitivity, 80.6, 87.5%, whereas P- and N- had high specificity, both 83.9% in CN vs aMCI + AD, 88.1% and 75.9% in CN + aMCI vs AD, respectively. In combination analysis, the PAR% of (C- and N-) were as high as (AW and HTS+).
The combination of (C- and N-) is as powerful as (AW and HTS+) in screening AD. Our findings provide novel insights for screening utility of brief questions "Consciousness of Impairment" and "Recent News."
随着认知能力下降患者人数的增加，医生和护理人员需要使用简短的筛查工具。综合神经认知测试需要专门的培训和评估时间。我们关注的是可及性，并比较了几个简单问题的诊断能力。
“Attended With”（AW）和“Head-Turning Sign”（HTS）因素以及参与者对以下问题的回答被记录下来：“您是否觉得现在在日常生活中比以前遇到了更多的困难？”[无意识（C-）或有意识+（C+）]，“您能告诉我您的日常乐趣或消遣吗？”[无乐趣（P-）或乐趣+（P+）]，“当前/最近有哪些显著的新闻/话题？”[无新闻（N-）或新闻+（N+）]。
这项研究于 2016 年 5 月至 2019 年 7 月在我们的记忆诊所进行。
我们纳入了 162 例连续病例（44 例认知正常（CN），55 例遗忘型轻度认知障碍（aMCI），48 例阿尔茨海默病（AD））。
计算了每个测试的灵敏度和特异性，并根据这些数字，计算了（AW 和 HTS+）、（C-和 P-）、（C-和 N-）、（P-和 N-）的人群归因风险百分比（PAR%），分别为问题组合分析。
AW 具有高灵敏度，分别为 87.4%、95.8%（CN 与 aMCI+AD、CN+aMCI 与 AD），而 HTS 的灵敏度仅为 46.4%、57.7%，HTS 特异性高，分别为 100.0%、71.8%。C-具有高灵敏度，分别为 80.6%、87.5%，而 P-和 N-具有高特异性，均为 83.9%（CN 与 aMCI+AD），88.1%和 75.9%（CN+aMCI 与 AD）。在组合分析中，（C-和 N-）的 PAR%与（AW 和 HTS+）一样高。
（C-和 N-）的组合在 AD 筛查中与（AW 和 HTS+）一样强大。我们的发现为简短问题“意识障碍”和“最近新闻”的筛查效用提供了新的见解。
