Tainta M, Iriondo A, Ecay-Torres M, Estanga A, de Arriba M, Barandiaran M, Clerigue M, Garcia-Sebastian M, Villanua J, Izagirre A, Saldias J, Aramburu A, Taboada J, Múgica J, Barandiaran A, Arrospide A, Mar J, Martinez-Lage P
CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain; Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, Spain; Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Guipúzcoa, Spain.
CITA Alzheimer, Donostia-San Sebastián, Guipúzcoa, Spain.
Neurologia (Engl Ed). 2024 Nov-Dec;39(9):781-791. doi: 10.1016/j.nrleng.2022.08.001. Epub 2022 Aug 10.
Brief cognitive tests (BCT) are used in primary care (PC) for the detection of cognitive impairment (CI). Still, there are little data on their diagnostic utility (DU) in a community setting. This work evaluates the DU at the population level of Fototest, T@M, AD8 questionnaire and MMSE. It provides new cut-off points (CoP) validated in a CI early detection program.
In the population and validation samples, the evaluation was carried out in two phases, a first of screening and administration of BCT and a second of clinical diagnosis, blinded to the results of the BCT, applying the current NIA-AA criteria. The DU of BCT in the population sample was evaluated with the area under the ROC curve (aROC). Youden index and the CoP with the best specificity that ensured a sensitivity of 80% were used to decide on the most appropriate CoP. The sensitivity, specificity, and predictive values for these CoP were calculated in the validation sample.
260 participants (23.1% with CI) from the population sample and 177 (42.4% with CI) from the validation sample were included. The Fototest has the best UD at the population level (aROC 0.851), which improves with the combination of Fototest and AD8 (aROC 0.875). The proposed CoP are AD8 ≥ 1, Fototest ≤ 35, T@M ≤ 40, and MMSE ≤ 26.
BCT are helpful in detecting CI in PC. This work supports the use of more demanding PoC.
简易认知测试（BCT）用于初级保健（PC）中认知障碍（CI）的检测。然而，关于其在社区环境中的诊断效用（DU）的数据仍然很少。本研究评估了Fototest、T@M、AD8问卷和MMSE在人群水平上的DU。它提供了在CI早期检测项目中验证的新的截断点（CoP）。
在人群样本和验证样本中，评估分两个阶段进行，第一阶段是BCT的筛查和实施，第二阶段是临床诊断，对BCT结果进行盲法处理，并应用当前的NIA-AA标准。用ROC曲线下面积（aROC）评估人群样本中BCT的DU。使用约登指数和确保灵敏度为80%的最佳特异性的CoP来确定最合适的CoP。在验证样本中计算这些CoP的灵敏度、特异性和预测值。
纳入了人群样本中的260名参与者（23.1%患有CI）和验证样本中的177名参与者（42.4%患有CI）。Fototest在人群水平上具有最佳的UD（aROC 0.851），与Fototest和AD8联合使用时有所提高（aROC 0.875）。建议的CoP为AD8≥1、Fototest≤35、T@M≤40和MMSE≤26。
BCT有助于在初级保健中检测CI。本研究支持使用要求更高的即时检验。
