Yu Jie, Lu Shou-Rong, Wang Zhuo, Yang Yin, Zhang Bin-Shan, Xu Qiao, Kan Hong
Department of Geriatrics, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China.
World J Psychiatry. 2023 Jul 19;13(7):478-485. doi: 10.5498/wjp.v13.i7.478.
The role of comprehensive geriatric assessment (CGA) in screening for mild cognitive disorders was not known.
To evaluate the role of CGA in screening for mild cognitive disorders.
A total of 100 elderly people who underwent health examinations in our hospital and community between January 2020 and December 2021 were included for analysis. Using Petersen as the diagnostic gold standard, healthy individuals were included in the control group and patients with mild cognitive impairment were assigned to the study group. The correlation between the cognitive function of the patients and their baseline clinical profiles was analyzed. Patients' Montreal Cognitive Assessment (MoCA) and CGA screening results were compared, and the sensitivity and specificity were calculated to assess the screening role of CGA.
CGA assessment yielded higher diagnostic accuracy than MoCA. The results of the multivariate regression analysis showed no correlation of gender, age, body mass index and literacy with cognitive function. Patients with mild cognitive impairment obtained significantly lower MoCA scores than healthy individuals ( < 0.05). In the CGA scale, patients with mild cognitive impairment showed significantly lower Mini-mental State Examination, Miniature Nutritional Assessment and Berg Balance Scale scores, and higher Activity of Daily Living, Instrumental Activities of Daily Living Scale and Frailty Screening Inventory scores than healthy individuals ( < 0.05), whereas the other assessment scales showed no significant differences ( > 0.05). The CGA provides higher diagnostic sensitivity and specificity than the MoCA ( < 0.05).
CGA allows accurate identification of mild cognitive impairment with high sensitivity and specificity, facilitating timely and effective intervention, and is thus recommended for clinical use.
综合老年评估（CGA）在筛查轻度认知障碍中的作用尚不清楚。
评估CGA在筛查轻度认知障碍中的作用。
纳入2020年1月至2021年12月期间在我院及社区接受健康检查的100名老年人进行分析。以彼得森法作为诊断金标准，将健康个体纳入对照组，将轻度认知障碍患者分配至研究组。分析患者认知功能与其基线临床特征之间的相关性。比较患者的蒙特利尔认知评估（MoCA）和CGA筛查结果，并计算敏感性和特异性以评估CGA的筛查作用。
CGA评估的诊断准确性高于MoCA。多因素回归分析结果显示，性别、年龄、体重指数和文化程度与认知功能无相关性。轻度认知障碍患者的MoCA得分显著低于健康个体（<0.05）。在CGA量表中，轻度认知障碍患者的简易精神状态检查表、微型营养评定量表和伯格平衡量表得分显著低于健康个体，而日常生活活动能力量表、工具性日常生活活动量表和衰弱筛查量表得分则高于健康个体（<0.05），而其他评估量表无显著差异（>0.05）。CGA的诊断敏感性和特异性高于MoCA（<0.05）。
CGA能够以高敏感性和特异性准确识别轻度认知障碍，有助于及时有效的干预，因此推荐临床使用。
