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蒙特利尔认知评估量表对于鉴别阿尔茨海默病、额颞叶痴呆、路易体痴呆和血管性痴呆是否是一项有价值的测试?

Is Montreal Cognitive Assessment a valuable test for the differentiation of Alzheimer's disease, frontotemporal dementia, dementia with Lewy body, and vascular dementia?

作者信息

Afrashteh Fatemeh, Almasi-Dooghaee Mostafa, Kamyari Naser, Rajabi Rayan, Baradaran Hamid Reza

机构信息

Iran University of Medical Sciences, School of Medicine, Tehran, Iran.

Iran University of Medical Sciences, Department of Neurology, Firoozgar Clinical Research Development Center (FCRDC), Tehran, Iran.

出版信息

Dement Neuropsychol. 2024 Aug 26;18:e20230124. doi: 10.1590/1980-5764-DN-2023-0124. eCollection 2024.

Abstract

UNLABELLED

Dementia is one of the growing diseases in the world and has different types based on its definition. The Montreal Cognitive Assessment (MoCA) test has been employed to screen patients with dementia, cognitive impairment, and disruption of daily activities.

OBJECTIVE

This study examined the diagnostic value of the total MoCA score and its subscores in differentiating Alzheimer's disease (AD), frontotemporal dementia (FTD), dementia with Lewy body (DLB), and vascular dementia (VaD).

METHODS

A total of 241 patients (AD=110, FTD=90, DLB=28, and VaD=13) and 59 healthy persons, who were referred to a dementia clinic with memory impairment in Firoozgar Hospital, were included in this study. MoCA tests were performed in all patients and normal persons.

RESULTS

By using the receiver operating characteristic (ROC) curve and measuring the area under the curve (AUC) for the total MoCA score in each group, AUC was 0.616, 0.681, 0.6117, and 0.583 for differentiating AD, FTD, DLB, and VaD patients, respectively. Among the groups, just the VaD group showed no significant usefulness in using the total MoCA score to differentiate it. To compare MoCA subscores, AD patients had higher scores in digit span, literal fluency, and abstraction but lower delayed recall scores compared with FTD patients.

CONCLUSION

The total MoCA score and its subscores could not differentiate people with different types of dementia in the setting of screening.

摘要

未标注

痴呆症是世界上日益增多的疾病之一,根据其定义有不同类型。蒙特利尔认知评估(MoCA)测试已被用于筛查患有痴呆症、认知障碍和日常活动中断的患者。

目的

本研究探讨MoCA总分及其子分数在区分阿尔茨海默病(AD)、额颞叶痴呆(FTD)、路易体痴呆(DLB)和血管性痴呆(VaD)方面的诊断价值。

方法

本研究纳入了共241例患者(AD = 110例,FTD = 90例,DLB = 28例,VaD = 13例)以及59名健康人,这些患者和健康人因记忆障碍被转诊至菲罗兹加尔医院的痴呆症诊所。所有患者和正常人都进行了MoCA测试。

结果

通过使用受试者工作特征(ROC)曲线并测量每组中MoCA总分的曲线下面积(AUC),区分AD、FTD、DLB和VaD患者时,AUC分别为0.616、0.681、0.6117和0.583。在这些组中,只有VaD组在使用MoCA总分进行区分时没有显示出显著的有效性。为了比较MoCA子分数,与FTD患者相比,AD患者在数字广度、文字流畅性和抽象能力方面得分较高,但延迟回忆得分较低。

结论

在筛查背景下,MoCA总分及其子分数无法区分不同类型痴呆症患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/978f/11348881/168c93036ad3/1980-5764-DN-18-e20230124-gf01.jpg

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