使用结合社会人口学因素的修订版Addenbrooke认知检查子分数算法预测阿尔茨海默病所致痴呆和行为变异型额颞叶痴呆

Predicting Dementia Due to Alzheimer's Disease and Behavioral Variant Frontotemporal Dementia Using Algorithms with the Addenbrooke's Cognitive Examination-Revised Subscores Combined with Sociodemographic Factors.

作者信息

Amaral-Carvalho Viviane, Bento Lima-Silva Thais, Inácio Mariano Luciano, de Souza Leonardo Cruz, Cerqueira Guimarães Henrique, Santoro Bahia Valeria, Nitrini Ricardo, Tonidandel Barbosa Maira, Sanches Yassuda Mônica, Caramelli Paulo

机构信息

Programa de Pós-Graduação em Neurologia, Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.

Behavior and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

出版信息

Curr Alzheimer Res. 2023;20(5):341-349. doi: 10.2174/1567205020666230816160700.

DOI:10.2174/1567205020666230816160700

PMID:37587822

Abstract

BACKGROUND

Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are important causes of dementia with challenging differential diagnoses in many cases. Addenbrooke's Cognitive Examination-Revised (ACE-R) is a cognitive battery that may be useful to differentiate the two disorders.

OBJECTIVE

The objectibe of this study is to investigate the value of the ACE-R combined with sociodemographic factors in the differential diagnosis between AD and bvFTD.

METHODS

The ACE-R was administered to 102 patients with mild dementia due to probable AD, 37 with mild bvFTD, and 135 controls. Performances of patients and controls were analyzed by logistic regression and by ROC curves to refine the diagnostic accuracy of the ACE-R in AD and bvFTD.

RESULTS

The ACE-R subscores Attention and Orientation, Fluency, and Memory, in combination with schooling differentiated AD from controls with an area under the ROC curve (AUC) of 0.936 (86% sensitivity and 87% specificity). The ACE-R subscores Attention and Orientation, Fluency, and Language, in combination with sex (male), age, and schooling, discriminated bvFTD from controls with an AUC of 0.908 (81% sensitivity and 95% specificity). In the differentiation between AD and bvFTD, the ACE-R subscores Attention and Orientation, Fluency, and Language, together with age, displayed an AUC of 0.865 (78% sensitivity and 85% specificity).

CONCLUSION

The combination of ACE-R scores with sociodemographic data allowed good differentiation between AD and bvFTD in the study sample.

摘要

背景

阿尔茨海默病（AD）和行为变异型额颞叶痴呆（bvFTD）是痴呆的重要病因，在许多病例中鉴别诊断具有挑战性。修订版Addenbrooke认知检查（ACE-R）是一种认知测试组合，可能有助于区分这两种疾病。

目的

本研究的目的是探讨ACE-R结合社会人口学因素在AD和bvFTD鉴别诊断中的价值。

方法

对102例可能患有AD的轻度痴呆患者、37例轻度bvFTD患者和135例对照者进行ACE-R测试。通过逻辑回归和ROC曲线分析患者和对照者的表现，以提高ACE-R在AD和bvFTD中的诊断准确性。

结果

ACE-R的注意力与定向、语言流畅性和记忆子分数，结合受教育程度，可将AD与对照者区分开来，ROC曲线下面积（AUC）为0.936（敏感性86%，特异性87%）。ACE-R的注意力与定向、语言流畅性和语言子分数，结合性别（男性）、年龄和受教育程度，可将bvFTD与对照者区分开来，AUC为0.908（敏感性81%，特异性95%）。在AD和bvFTD的鉴别中，ACE-R的注意力与定向、语言流畅性和语言子分数，连同年龄，AUC为0.865（敏感性78%，特异性85%）。