FIDYAN Neurocenter, Granada, Spain.
Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Neurologia (Engl Ed). 2022 Jul-Aug;37(6):441-449. doi: 10.1016/j.nrleng.2019.05.011. Epub 2022 Apr 30.
This study aims to assess and compare the diagnostic performance of brief cognitive tests for cognitive impairment (CI) screening recommended by the Spanish guidelines for the integral care of people with Alzheimer's disease and other dementias.
We performed a phase iii study into the accuracy of diagnostic tests, including patients with suspected CI in a primary care setting. All patients completed the Mini-Mental State Examination (MMSE), the Mini Examen Cognoscitivo (MEC), the Short Portable Mental Status Questionnaire (SPMSQ), the Memory Impairment Screen (MIS), the Clock Drawing Test (CDT), the Eurotest, the Fototest, and the Memory Alteration Test (M@T). CI was diagnosed independently by researchers blinded to scores on these tests. Diagnostic performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC).
The study included 141 individuals (86 with CI). The Eurotest and M@T (AUC±SE: 0.91±0.02 and 0.90±0.02, respectively) took longer to administer (mean [SD]: 7.1 [1.8] and 6.8 [2.2]min, respectively) and have significantly better diagnostic performance compared to the MMSE, MEC, SPMSQ, and CDT, but not compared to MIS or Fototest (both with an AUC of 0.87±0.03), with the latter taking less than half as long to administer (2.8 [0.8]min). The M@T and MIS only evaluate memory, and the latter cannot be administered to illiterate people.
The most advisable tests for CI screening in primary care are the Eurotest, M@T, and Fototest, with the latter being the most efficient as it takes half as long to administer.
本研究旨在评估和比较西班牙综合阿尔茨海默病及其他痴呆患者护理指南推荐的用于认知障碍（CI）筛查的简短认知测试的诊断性能。
我们进行了一项 III 期诊断测试准确性研究，包括在初级保健环境中疑似 CI 的患者。所有患者均完成简易精神状态检查（MMSE）、简易认知评估量表（MEC）、简短便携式精神状态问卷（SPMSQ）、记忆障碍筛查（MIS）、画钟测验（CDT）、欧洲认知测验（Eurotest）、照片认知测验（Fototest）和记忆改变测试（M@T）。CI 由对这些测试评分不了解的研究人员独立诊断。通过计算接收者操作特征曲线下的面积（AUC）来评估诊断性能。
该研究纳入了 141 名患者（86 名患有 CI）。Eurotest 和 M@T（AUC±SE：0.91±0.02 和 0.90±0.02）的评估时间更长（分别为 7.1[1.8]和 6.8[2.2]分钟），与 MMSE、MEC、SPMSQ 和 CDT 相比，具有显著更好的诊断性能，但与 MIS 或 Fototest（AUC 均为 0.87±0.03）相比，没有更好的诊断性能，后者的评估时间不到一半（2.8[0.8]分钟）。M@T 和 MIS 仅评估记忆，后者无法用于文盲患者。
在初级保健中用于 CI 筛查最明智的测试是 Eurotest、M@T 和 Fototest，后者的评估时间最短，为前者的一半。
