比较两种认知筛查工具在识别老年人脑灰质和白质损伤方面的功效。
Comparing the Efficacy of Two Cognitive Screening Tools in Identifying Gray and White Matter Brain Damage among Older Adults.
作者信息
Andreatta Maduro Paula, Guimarães Manoel Pereira, de Sousa Rodrigues Mateus, Pereira Rolim Coimbra Pinto Ana Paula, da Mota Junior Américo Alves, Lima Rocha Alaine Souza, Matoso Juliana Magalhães Duarte, Bavaresco Gambassi Bruno, Schwingel Paulo Adriano
机构信息
Post-Graduation Program in Health Sciences (PPGCS), University of Pernambuco (UPE), Recife, PE 50100-130, Brazil.
Human Performance Research Laboratory (LAPEDH), UPE, Petrolina, PE 56328-900, Brazil.
出版信息
J Aging Res. 2024 Apr 23;2024:5527225. doi: 10.1155/2024/5527225. eCollection 2024.
BACKGROUND
Ageing is associated with structural changes in brain regions and functional decline in cognitive domains. Noninvasive tools for identifying structural damage in the brains of older adults are relevant for early treatment.
AIMS
This study aims to evaluate and compare the accuracy of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA©) in identifying gray and white matter brain damage in older individuals with varying degrees of cognitive impairment.
METHODS
Ninety older adults (62 women) with an average age of 69 ± 7 years were enrolled and categorized as having no cognitive impairment (NCI), mild cognitive impairment (MCI), or moderate cognitive impairment (MoCI). Magnetic resonance imaging (MRI) was utilized to assess the number, volume, and distribution of brain damage. The Fazekas and Scheltens scales were applied to the brain MRIs, and inferential statistics were employed to compare variables among the groups.
RESULTS
Cognitive impairment was observed in 56.7% of the participants (95% confidence interval (CI): 46.4-66.4%), with thirty-six older adults (40%) classified as MCI and 15 (17%) as MoCI. Cognitive impairment and medial temporal lobe (MTL) atrophy were found to be associated (=0.001), exhibiting higher mean volume scales of the MTL atrophied area in the MoCI group ( < 0.001). The MMSE accurately revealed MTL atrophy based on the Scheltens ( < 0.05) and Fazekas ( < 0.05) scales. At the same time, the MoCA accurately identified periventricular white matter (PWM) abnormalities according to the Fazekas scale ( < 0.05).
CONCLUSIONS
The MMSE and MoCA screening tools effectively identified gray and white matter brain damage in older adults with varying degrees of cognitive impairment. Lower MMSE scores are associated with MTL atrophy and lesions, and lower MoCA scores are related to PWM lesions. The concurrent use of MMSE and MoCA is recommended for assessing structural changes in distinct brain regions.
背景
衰老与脑区结构变化及认知领域功能衰退相关。用于识别老年人脑结构损伤的非侵入性工具对早期治疗具有重要意义。
目的
本研究旨在评估和比较简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA©）在识别不同程度认知障碍老年人脑灰质和白质损伤方面的准确性。
方法
招募了90名平均年龄为69±7岁的老年人（62名女性），并将其分为无认知障碍（NCI）、轻度认知障碍（MCI）或中度认知障碍（MoCI）。利用磁共振成像（MRI）评估脑损伤的数量、体积和分布。将Fazekas和Scheltens量表应用于脑部MRI，并采用推断统计学方法比较各组间的变量。
结果
56.7%的参与者存在认知障碍（95%置信区间（CI）：46.4 - 66.4%），其中36名老年人（40%）被归类为MCI，15名（17%）为MoCI。发现认知障碍与内侧颞叶（MTL）萎缩相关（=0.001），MoCI组MTL萎缩区域的平均体积量表更高（<0.001）。MMSE根据Scheltens量表（<0.05）和Fazekas量表（<0.05）准确揭示了MTL萎缩。同时，MoCA根据Fazekas量表准确识别了脑室周围白质（PWM）异常（<0.05）。
结论
MMSE和MoCA筛查工具有效地识别了不同程度认知障碍老年人的脑灰质和白质损伤。较低的MMSE分数与MTL萎缩和病变相关，较低的MoCA分数与PWM病变相关。建议同时使用MMSE和MoCA来评估不同脑区的结构变化。
Zotero 插件