基于电子化的痴呆与认知障碍早期识别筛查和诊断流程的探讨  

Application of early recognition screening and diagnostic scale of dementia and cognitive impairment based on electronization

作　　者：蒋平静 谭小林[1] 于婷婷 程雪[1] 彭晶晶[1] 胡舒[1] 李远[1] 赵新民[1] JIANG Ping-jing;TAN Xiao-lin;YU Ting-ting;CHENG Xue;PENG Jing-jing;HU Shu;LI Yuan;ZHAO Xin-min(Chongqing Mengtal Health Center,Chongqing 401147,China)

机构地区：[1]重庆市精神卫生中心,重庆401147

出　　处：《阿尔茨海默病及相关病杂志》2021年第2期116-120,共5页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：重庆市精神卫生中心院级科研项目资助(2019-yjkt-01)。

摘　　要：目的:探讨建立基于电子化的痴呆与认知障碍早期识别筛查和诊断流程。方法:筛选确定适合痴呆与认知障碍筛查和诊断的评定量表8个:记忆障碍自评量表(ascertain dementia 8 questionnaire,AD8)、易管理的简短认知筛查量表(mini coginitive testing,Mini-cog)、谵妄评定方法(The confusion Assessment Method,CAM)、总体衰退量表(gobal deterioration scale,GDS)、日常生活能力量表(activity of daily living,ADL)、简易智力状态检查(mini-mental state examination,MMSE)、蒙特利尔认知评估量表(montreal cognitive assessment,MOCA)、神经精神科问卷(neuropsychiatric inventory,NPI)。研究组通过软件工程师设计的患者或家属能在手机上完成自评的小程序进行测试,对照组采用人工测试,分别对电子化筛查量表的效度和时间效率进行比较和分析,结合相关临床检查及诊断标准构建早期识别筛查和诊断系统。结果:(1)电子版的AD8、Min-cog、ADL、CAM、MMSE、MOCA在不同诊断组别评分差异均有统计学意义(P<0.01),AD8与Min-cog、MMSE与MOCA评分相关均有统计学意义(P<0.01),AD8、ADL、MMSE、MOCA、CAM的RUC值均在0.90以上。(2)电子版测试与人工测试各量表评分、完成时间相关均有统计学意义(P<0.05),前者的时间效率节省了33.98%。结论:电子版的认知功能筛查和诊断量表效度、效率和诊断价值相对于人工测试较高,适宜在社区和记忆门诊推广应用。Objective:To establish an electronic screening and diagnosis process for early recognition of dementia and cognitive impairment.Methods:Eight assessment scales(AD8、Mini-cog、CAM、GDS、ADL、MMSE、MOCA、NPI)were selected for the screening and diagnosis of dementia and cognitive impairment.The research group was tested by a small program designed by a software engineer that patients or their families could complete self-assessment on their mobile phones,the validity and time efficiency of the electronic screening scale were compared and analyzed by manual test in the control group,and combined with the relevant clinical examination and diagnostic criteria,the early identification screening and diagnosis system was constructed.Results:(1)the scores of AD8、Min-cog、ADL、CAM、MMSE、MOCA in different diagnosis groups were statistically significant(P<0.01),the RUC values of AD8、ADL、MMSE、MOCA、CAM were all above 0.90.(2)The time efficiency of the former was 33.98%less than that of the former.Conclusion:the validity,efficiency and diagnostic value of the electronic cognitive function screening and diagnosis scale are better than the manual test,which is suitable for the promotion and application in community and memory clinic.

关 键 词：认知障碍 痴呆 早期识别筛查 电子版测试 

分 类 号：R749.1[医药卫生—神经病学与精神病学]