北京地区蒙特利尔认知量表的应用研究  

The application of Montreal cognitive assessment in urban Chinese residents of Beijing

作　　者：温洪波[1] 张振馨[1] 牛富生[1] 李凌[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院神经内科,100730

出　　处：《中华内科杂志》2008年第1期36-39,共4页Chinese Journal of Internal Medicine

摘　　要：目的研究蒙特利尔认知量表（MoCA）测试结果的分布特征，为制定适合我国国情的筛查分界值标准提供科学的依据。方法通过随机抽样，以北京市≥50岁215例正常人群和66例轻度认知功能障碍（MCI）人群为样本。总结其MoCA测试结果的百分位数值和均值的年龄、性别和受教育程度分布，比较MoCA和简易精神状态量表（MMSE）检测MCI的效度。按MoCA和MMSE建立多元线性回归方程，分析影响测试结果的因素。结果MoCA的分界值≥26分，年龄和受教育程度诸因素均对MoCA得分有显著影响（P〈0．001）。检测MCI的敏感度MoCA为92．4％，显著优于MMSE的24．2％。结论MoCA用于筛查MCI病例优于MMSE。调整的分界值标准有助于早期发现MCI和痴呆病人，减少漏诊。MoCA得分是判断认知功能是否正常的非特异性指标，不能取代临床诊断。Objective To study the distribution of Montreal cognitive assessment （MoCA） scores in terms of age and educational level in Chinese residents aged 50 years and over and to offer a benchmark for a cutoff score. Methods A total of 281 residents aged 50 years or older was drawn randomly in the urban areas of Beijing, including 215 healthy elderly controls （NC） and 66 patients meeting the clinical criteria of mild cognitive impairment （MCI）. The final scores for MoCA were given in the form of mean percentage distributions specific for age, sex and educational level so as to compare the validity of MMSE mini-mental state examination and MoCA in detecting MCI. By a fitting multiple regression model the influence of the factors on MMSE and MoCA was assessed. Results Using a cutoff score of 26, MMSE had a sensitivity of 24. 2% to detect MCI, whereas MoCA detected 92. 4% of the MCI subjects. We found a bivariate correlation between MoCA scores and both the factors of age and educational level （ P 〈 0. 001 ）. Conclusions MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing normally on MMSE. Our adjustment in the cutoff scores would improve the detection of MCI and Alzheimer＇s disease by reducing the number of false negatives. MoCA scores should be used to identify current cognitive difficulties but not to make formal diagnoses.

关 键 词：认知障碍 蒙特利尔认知量表 数据收集 

分 类 号：R686[医药卫生—骨科学]