Alšauskė Silvija Valdonė, Grabauskytė Ingrida, Liseckienė Ida, Macijauskienė Jūratė
Family Medicine Clinic, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
Department of Physics, Mathematics and Biophysics, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
Medicina (Kaunas). 2025 Jan 14;61(1):122. doi: 10.3390/medicina61010122.
: The aging population has led to a rise in cognitive impairments, including dementia, often associated with multimorbidity. Early diagnosis of cognitive decline is crucial, especially in primary care, where time constraints and the limitations of diagnostic tools may hinder accurate detection. This study aims to assess the cognitive functions of multimorbid patients using the Mini-Mental State Examination (MMSE) and the Lithuanian version of the General Practitioner Assessment of Cognition (LT-GPCOG). We hypothesized that the LT-GPCOG would perform similarly to the MMSE in suspecting cognitive impairments. : This cross-sectional study, conducted from 2021 to 2022, included 796 patients aged 40-85, with arterial hypertension and at least one other chronic disease, recruited from seven Lithuanian primary health care centers. Cognitive function was assessed using the MMSE and LT-GPCOG, and statistical analyses were performed using SPSS to determine the association between cognitive impairment and various demographic and clinical variables. : Out of 796 participants, 793 completed the study. Cognitive impairment was suspected in 5.1% of participants based on MMSE and 4.2% based on the LT-GPCOG. Statistically significant associations were found between cognitive impairment and chronic obstructive pulmonary disease (COPD) ( = 0.008 and = 0.003) in both tests and chronic kidney disease (CKD) ( = 0.005) while testing with the MMSE. Lower education and unemployment were also correlated with cognitive impairment ( = 0.008 and < 0.001). : The findings suggest that regular cognitive assessments should be integrated into the management of multimorbid patients, particularly those with COPD and CKD. The LT-GPCOG proved to be an efficient alternative to the MMSE in primary care settings, demonstrating comparable diagnostic accuracy. Further studies are also needed to assess the sensitivity and specificity of the LT-GPCOG test.
老龄化人口导致认知障碍(包括痴呆症)的发生率上升,这些认知障碍通常与多种疾病并存有关。认知能力下降的早期诊断至关重要,尤其是在初级保健中,时间限制和诊断工具的局限性可能会阻碍准确检测。本研究旨在使用简易精神状态检查表(MMSE)和立陶宛语版全科医生认知评估量表(LT-GPCOG)评估患有多种疾病的患者的认知功能。我们假设LT-GPCOG在怀疑认知障碍方面的表现与MMSE相似。
这项横断面研究于2021年至2022年进行,纳入了796名年龄在40 - 85岁之间、患有动脉高血压且至少患有一种其他慢性病的患者,这些患者来自立陶宛的七个初级卫生保健中心。使用MMSE和LT-GPCOG评估认知功能,并使用SPSS进行统计分析,以确定认知障碍与各种人口统计学和临床变量之间的关联。
在796名参与者中,793人完成了研究。基于MMSE,5.1%的参与者被怀疑存在认知障碍;基于LT-GPCOG,这一比例为4.2%。在两项测试中,均发现认知障碍与慢性阻塞性肺疾病(COPD)(P = 0.008和P = 0.003)以及在使用MMSE测试时与慢性肾病(CKD)(P = 0.005)之间存在统计学上的显著关联。较低的教育水平和失业也与认知障碍相关(P = 0.008和P < 0.001)。
研究结果表明,应将定期认知评估纳入患有多种疾病患者的管理中,特别是那些患有COPD和CKD的患者。在初级保健环境中,LT-GPCOG被证明是MMSE的一种有效替代方法,具有相当的诊断准确性。还需要进一步研究来评估LT-GPCOG测试的敏感性和特异性。