Alfano Dennis P, Grummisch Julia A, Gordon Jennifer L, Hadjistavropoulos Thomas
Department of Psychology, University of Regina, Regina, SK, Canada.
Arch Clin Neuropsychol. 2022 Jul 19;37(5):873-890. doi: 10.1093/arclin/acac026.
A neuropsychological approach to the detection and classification of mild cognitive impairment (MCI) using "gold standard" clinical ratings (CRs) was examined in a sample of independently functioning community dwelling seniors. The relationship between CRs and life satisfaction, concurrent validity of cognitive screening measures, and agreement between CRs and existing criteria for MCI were also determined.
One hundred and forty-two participants, aged 75 years and older, were administered a comprehensive battery of neuropsychological tests, along with self-report measures of psychological and psychosocial functioning, and functional independence. CRs were based on demographically corrected neuropsychological variables.
The prevalence of MCI identified using CRs in this sample was 26.1%. Single and multiple domain subtypes of MCI were readily identified with subtypes reflecting Amnestic and Executive Function impairment predominating. Executive Function was a significant predictor of Life Satisfaction. The MoCA and MMSE both showed weak performance in detecting MCI based on CRs. There was substantial agreement between CRs and the classification criteria for MCI defined by Petersen/Winblad and Jak/Bondi. A global deficit score had near perfect performance as a proxy for CRs in detecting MCI in this sample.
The results provide strong support for the utility of neuropsychological CRs as a "gold standard" operational definition in the detection and classification of MCI in older adults.
在一个独立生活的社区老年人样本中，研究一种使用“金标准”临床评定（CRs）来检测和分类轻度认知障碍（MCI）的神经心理学方法。还确定了CRs与生活满意度之间的关系、认知筛查措施的同时效度，以及CRs与现有MCI标准之间的一致性。
对142名75岁及以上的参与者进行了一系列全面的神经心理学测试，以及心理和社会心理功能及功能独立性的自我报告测量。CRs基于经人口统计学校正的神经心理学变量。
在该样本中，使用CRs确定的MCI患病率为26.1%。MCI的单领域和多领域亚型很容易被识别出来，以反映遗忘和执行功能损害的亚型为主。执行功能是生活满意度的一个重要预测因素。基于CRs，蒙特利尔认知评估量表（MoCA）和简易精神状态检查表（MMSE）在检测MCI方面表现都较弱。CRs与彼得森/温布拉德（Petersen/Winblad）和雅克/邦迪（Jak/Bondi）定义的MCI分类标准之间有很大的一致性。在该样本中，一个总体缺陷分数作为CRs的替代指标在检测MCI方面表现近乎完美。
研究结果为神经心理学CRs作为老年人MCI检测和分类中的“金标准”操作定义的实用性提供了有力支持。
