Adachi Takuji, Tsunekawa Yuki, Matsuoka Akihito, Tanimura Daisuke
Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Rehabilitation, Nagoya Ekisaikai Hospital, Nagoya, Japan.
J Geriatr Cardiol. 2021 Apr 28;18(4):245-251. doi: 10.11909/j.issn.1671-5411.2021.04.001.
Cognitive decline is common among older patients with cardiovascular disease (CVD) and can decrease their self-management abilities. However, the instruments for identifying mild cognitive impairment (MCI) are not always feasible in clinical practice. Therefore, this study evaluated whether MCI could be detected using the Japanese version of the Rapid Dementia Screening Test (RDST-J), which is a simple screening tool for identifying cognitive decline.
This retrospective single-center study included patients who were ≥ 65 years old and hospitalized because of CVD. Patients with a pre-hospitalization diagnosis of dementia were excluded. Each patient's cognitive function had been measured at discharge using the RDST-J and the Japanese version of the Montreal Cognitive Assessment (MoCA-J), which is a standard tool for MCI screening. The correlation between the two scores was evaluated using Spearman's rank correlation coefficient. Receiver operating characteristic (ROC) analysis was also to evaluate whether the RDST-J could identify MCI, which was defined as a MoCA-J score of ≤ 25 points.
The study included 78 patients (mean age: 77.2 ± 8.9 years). The RDST-J and MoCA-J scores were strongly correlated ( = 0.835, < 0.001). The ROC analysis revealed that an RDST-J score of ≤ 9 points provided 75.4% sensitivity and 95.2% specificity for identifying MCI, with an area under the curve of 0.899 (95% CI: 0.835-0.964). The same cut-off value was identified when excluding patients with a high probability of dementia (RDST-J score of ≤ 4 points).
The RDST-J may be a simple and effective tool for identifying MCI in older patients with CVD.
认知功能减退在老年心血管疾病（CVD）患者中很常见，并且会降低他们的自我管理能力。然而，用于识别轻度认知障碍（MCI）的工具在临床实践中并不总是可行的。因此，本研究评估了是否可以使用日本版快速痴呆筛查测试（RDST-J）来检测MCI，RDST-J是一种用于识别认知功能减退的简单筛查工具。
这项回顾性单中心研究纳入了年龄≥65岁且因CVD住院的患者。排除入院前诊断为痴呆的患者。每位患者在出院时使用RDST-J和日本版蒙特利尔认知评估量表（MoCA-J）测量认知功能，MoCA-J是MCI筛查的标准工具。使用Spearman等级相关系数评估两个评分之间的相关性。还进行了受试者工作特征（ROC）分析，以评估RDST-J是否能够识别MCI，MCI定义为MoCA-J评分≤25分。
该研究纳入了78例患者（平均年龄：77.2±8.9岁）。RDST-J评分与MoCA-J评分高度相关（ = 0.835， < 0.001）。ROC分析显示，RDST-J评分≤9分对识别MCI的灵敏度为75.4%，特异度为95.2%，曲线下面积为0.899（95%CI：0.835 - 0.964）。在排除痴呆高概率患者（RDST-J评分≤4分）时，确定了相同的临界值。
RDST-J可能是识别老年CVD患者MCI的一种简单有效的工具。
