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蒙特利尔认知评估量表(MoCA)在全科医疗中用于认知障碍早期检测的可行性研究

Montreal Cognitive Assessment (MoCA) use in general practice for the early detection of cognitive impairment: a feasibility study.

作者信息

Carton Cassandre, Calafiore Matthieu, Cauet Charles, Messaadi Nassir, Bayen Marc, Wyts David, Messaadi Wassil, Richebe Teddy, Bayen Sabine

机构信息

District of General Medicine, Faculty of Medicine, University of Lille, Lille, France.

University of Lille, CHU Lille, ULR 2694 - MSPU Wattrelos, Lille, France.

出版信息

BJGP Open. 2025 Apr 24;9(1). doi: 10.3399/BJGPO.2024.0039. Print 2025 Apr.

Abstract

BACKGROUND

GPs can detect cognitive impairment (CI) at a very early stage, allowing early support for people and their caregivers. The early onset of CI is between 50 years and 60 years. Currently, in France, the Mini-Mental State Examination (MMSE) remains the most used screening test, although it has a lower sensitivity and specificity than the Montreal Cognitive Assessment (MoCA) for detecting mild CI, taking an average of 15 minutes to complete.

AIM

To investigate the feasibility of the MoCA during routine consultations in general practice for the early detection of CI and to determine prevalence of CI in a primary care setting.

DESIGN & SETTING: A quantitative, prospective feasibility study was carried out in real-life working conditions during routine GP consultations in France.

METHOD

GPs performed MoCA on adults aged ≥50 years, without suspected or confirmed CI.

RESULTS

Sixty-one GPs performed 221 MoCA with a mean duration of 8 minutes and detected mild neurocognitive impairment in 62% of patients.

CONCLUSION

The MoCA is feasible and easy to perform during routine consultations in general practice by trained and experienced physicians.

摘要

背景

全科医生(GPs)能够在认知障碍(CI)的极早期阶段就进行检测,从而能为患者及其照护者提供早期支持。CI的早期发病年龄在50岁至60岁之间。目前在法国,简易精神状态检查表(MMSE)仍是使用最广泛的筛查测试,不过在检测轻度CI方面,其敏感性和特异性低于蒙特利尔认知评估量表(MoCA),且完成该测试平均需要15分钟。

目的

探讨在全科医疗的常规诊疗中使用MoCA进行CI早期检测的可行性,并确定初级保健机构中CI的患病率。

设计与设置

在法国全科医生常规诊疗的实际工作条件下开展了一项定量、前瞻性可行性研究。

方法

全科医生对年龄≥50岁、无疑似或确诊CI的成年人进行MoCA测试。

结果

61名全科医生进行了221次MoCA测试,平均时长为8分钟,并在62%的患者中检测出轻度神经认知障碍。

结论

对于经过培训且经验丰富的医生而言,在全科医疗的常规诊疗中使用MoCA是可行且易于操作的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8538/12138001/5042136c73dd/bjgpopen-9-0039-f1.jpg

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