Kumar Gurja John Preetham, Muthukrishnan Suriya Prakash, Tripathi Manjari, Mehta Nalin, Sharma Ratna
Stress and Cognitive Electroimaging Laboratory, Department of Physiology, AIIMS, New Delhi, India.
Department of Neurology, AIIMS, New Delhi, India.
Neurol India. 2022 May-Jun;70(3):1057-1063. doi: 10.4103/0028-3886.349605.
Cognition is impaired in Alzheimer's disease (AD) and patients with mild cognitive impairment (MCI) with varying levels of magnitude.
The present study aimed to identify a biomarker for classifying MCI and AD using multi-domain cognitive testing.
This was a cross-sectional study.
26 AD patients, 28 MCI patients and 25 controls were recruited. Cognitive assessment of different domains was done using standard questionnaires and cognitive function tests.
Cognitive task scores were compared between the groups using multivariate analysis of variance (MANOVA).
Patients with AD had significantly lower MMSE, CDR, cognitive task scores compared to controls and MCI. Cognitive scores of all tasks for MCI were significantly less than controls, except MMSE and digits forward score. ROC analysis showed that picture memory had 100% sensitivity, 91.6% specificity for AD and 88.4% sensitivity, 92.5% specificity for MCI. Word memory had 92.3% specificity, 100% specificity for AD and 80.7% specificity, 84.6% specificity for MCI.
The global cognitive tools are less specific in bringing out the differences especially between MCI and control. Limitation of MMSE, heterogeneity of MCI and differential impairment of various domains of cognition, demands the inclusion of multi-domain cognitive evaluation especially picture and word memory tasks with high sensitivity and specificity into the existing diagnostic protocol. ROC results also suggested the continuum of cognitive impairment and MCI as a transitional stage leaving more scope on the quantum of research required for intervention to halt the structural and functional decline.
阿尔茨海默病（AD）和轻度认知障碍（MCI）患者存在不同程度的认知功能损害。
本研究旨在通过多领域认知测试确定一种用于区分MCI和AD的生物标志物。
这是一项横断面研究。
招募了26例AD患者、28例MCI患者和25例对照。使用标准问卷和认知功能测试对不同领域进行认知评估。
采用多变量方差分析（MANOVA）比较各组的认知任务得分。
与对照组和MCI相比，AD患者的简易精神状态检查表（MMSE）、临床痴呆评定量表（CDR）和认知任务得分显著更低。除MMSE和顺背数字得分外，MCI所有任务的认知得分均显著低于对照组。受试者工作特征（ROC）分析显示，图片记忆对AD的敏感性为100%、特异性为91.6%，对MCI的敏感性为88.4%、特异性为92.5%。词语记忆对AD的特异性为92.3%、100%，对MCI的特异性为80.7%、84.6%。
整体认知工具在揭示差异方面特异性较低，尤其是在MCI和对照组之间。MMSE的局限性、MCI的异质性以及认知各领域的不同损害，要求在现有诊断方案中纳入多领域认知评估，尤其是具有高敏感性和特异性的图片和词语记忆任务。ROC结果还表明认知障碍的连续性以及MCI作为一个过渡阶段，这为干预以阻止结构和功能衰退所需的研究量留下了更多空间。
