Ren Hua, Feng Qiansen, Chen Lei, Li Linlin, Wang Jiayu, Wu Jiajing, Dong Li, Liu Tiejun, Wang Ziqi
The Clinical Hospital of Chengdu Brain Science Institute, Ministry of Education (MoE) Key Laboratory for NeuroInformation, School of Life Science and Technology, University of Electronic Science and Technology of China, The Fourth People's Hospital of Chengdu, Chengdu, China.
Nursing School of Zunyi Medical University, Guizhou, China.
Front Psychiatry. 2024 Oct 11;15:1429934. doi: 10.3389/fpsyt.2024.1429934. eCollection 2024.
Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are stages 2 and 3, respectively, of the Alzheimer's continuum. The Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog's) ten-words recall test is a validated method for the early detection of cognitive impairment in Alzheimer's disease. However, limited studies have investigated its ability to differentiate between SCD and MCI.
203 participants with SCD and 62 participants with MCI underwent multiple neuropsychological assessments. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment-Basic (MOCA-B) served as brief global cognition tests. A binary logistic regression model was used to analyze the potential factors affecting MCI. The accuracy of the ten-words recall test was assessed using the area under the receiver operating characteristic (ROC) and the area under the curve (AUC).
The neuropsychological assessment revealed significant differences in the ten-words recall test scores between the SCD (median age 61 years; 70.44% female) and MCI (median age 64 years; 61.29% female) groups ( < 0.001), with the MCI group scoring the highest. Using a cut-off value of 3.15 for the ten-words recall test, sensitivity for distinguishing MCI from SCD reached 87%, while specificity stood at 61% (AUC 0.777, < 0.001). DeLong's test indicated no statistically significant difference in the ten-words recall test's ability to distinguish between SCD and MCI compared to the total score of ADAS-Cog (AUC 0.833, ) and MMSE (AUC 0.784, > 0.05). However, a significant difference was observed when compared to MoCA-B (AUC 0.973, < 0.001). In the population with an education level of ≤ 9 years, the optimal cut-off value for the ten-words recall test was 3.15, yielding a sensitivity of 91% and a specificity of 45% (AUC = 0.674, = 0.030). In the population with an education level > 9 years, the optimal cut-off value was 3.63, resulting in a sensitivity of 79% and a specificity of 71% (AUC = 0.785, < 0.001).
The ten-words recall test from the ADAS-cog may detect MCI early owing to its simplicity and quick administration. It is an effective and convenient tool for rapidly identifying mild cognitive impairment.
主观认知下降（SCD）和轻度认知障碍（MCI）分别是阿尔茨海默病连续体的第2和第3阶段。阿尔茨海默病评估量表 - 认知分量表（ADAS - cog）的10个单词回忆测试是一种用于早期检测阿尔茨海默病认知障碍的有效方法。然而，研究其区分SCD和MCI能力的研究有限。
203名SCD参与者和62名MCI参与者接受了多项神经心理学评估。简易精神状态检查表（MMSE）和蒙特利尔认知评估基础版（MOCA - B）用作简短的整体认知测试。使用二元逻辑回归模型分析影响MCI的潜在因素。使用受试者操作特征曲线（ROC）下面积和曲线下面积（AUC）评估10个单词回忆测试的准确性。
神经心理学评估显示，SCD组（中位年龄61岁；女性占70.44%）和MCI组（中位年龄64岁；女性占61.29%）在10个单词回忆测试分数上存在显著差异（<0.001），MCI组得分最高。对于10个单词回忆测试，使用截断值3.15时，区分MCI与SCD的敏感性达到87%，特异性为61%（AUC 0.777，<0.001）。DeLong检验表明，与ADAS - Cog总分（AUC 0.833，）和MMSE（AUC 0.784，>0.05）相比，10个单词回忆测试区分SCD和MCI的能力在统计学上无显著差异。然而，与MoCA - B相比观察到显著差异（AUC 0.973，<0.001）。在教育水平≤9年的人群中，10个单词回忆测试的最佳截断值为3.15，敏感性为91%，特异性为45%（AUC = 0.674，= 0.030）。在教育水平>9年的人群中，最佳截断值为3.63，敏感性为79%，特异性为71%（AUC = 0.785，<0.001）。
ADAS - cog中的10个单词回忆测试因其简单性和快速实施，可能早期检测出MCI。它是快速识别轻度认知障碍的有效且便捷的工具。
