CDT、MMSE及MoCA在煤矿地区老年人认知功能障碍筛查中的效能  

The Efficacy of CDT,MMSE and MoCA in Screening Cognitive Impairment in the Elderly in Coal Mining Area

作　　者：米希婷[1] 孟涛 裴芳 王思思 张凯旋 王娟[1] 李亮[1] 刘卫华 尉杰忠 马存根 MI Xi-ting;MENG Tao;PEI Fang;WANG Si-si;ZHANG Kai-xuan;WANG Juan;LI Liang;LIU Wei-hua;YU Jie-zhong;MA Cun-gen(Shanxi Key Laboratory of Basic and Applied Research on Neuroinflammation and Degenerative Diseases,Medical School of Shanxi Datong University,Datong Shanxi,037009;Department of Neurology,Affiliated Hospital of Shanxi Datong University,Datong Shanxi,037009;Department of Neurology,The First Affiliated Hospital of Shanxi Datong University,Datong Shanxi,037009;The Fourth People's Hospital of Datong,Datong Shanxi,037009;Neurobiology Research Center,Shanxi University of Traditional Chinese Medicine,Taiyuan Shanxi,030000)

机构地区：[1]山西大同大学医学院神经炎症及变性疾病基础与应用研究/山西省重点实验室,山西大同037009 [2]山西大同大学附属医院神经内科,山西大同037009 [3]山西大同大学附属第一医院神经内科,山西大同037009 [4]大同市第四人民医院,山西大同037009 [5]山西中医药大学神经生物学研究中心,山西太原030000

出　　处：《山西大同大学学报（自然科学版）》2022年第2期75-80,共6页Journal of Shanxi Datong University(Natural Science Edition)

基　　金：山西省平台基地专项[201805D131005]、[201805D111009];山西省大同市社会发展重点研发计划项目[2019105]、[2019089];山西大同大学附属第一医院横向合作项目[HX-201927];山西大同大学重点实验室开放基金项目[KF2019005];大学生创新创业训练计划项目[2020463]、[XDC2019132]。

摘　　要：目的探讨不同画钟测验(CDT)评分系统、简易精神状态检查量表(MMSE)及蒙特利尔认知评估量表(MoCA)在煤矿地区老年人认知功能障碍筛查中的效能。方法招募大同煤矿地区认知障碍老年患者85例,以及认知正常老年人95例,应用CDT-Lin、CDT-Royall、MMSE和MoCA对两组老年人认知功能进行量化评分,比较两组人群基本信息和各项认知评分,绘制各量表认知筛查受试者工作特征(ROC)曲线,比较各量表认知筛查的灵敏度和特异度。结果两组人群在性别、年龄、受教育年限、体质指数、吸烟和饮酒情况、社会活动情况、体育锻炼情况、独居情况等均无统计学差异;认知障碍组CDT-Lin、CDT-Royall、MMSE和MoCA认知评分显著低于认知正常组。CDT-Lin、CDT-Royall、MMSE和MoCA认知筛查曲线下面积分别为60.1%、62.3%、80.5%和86.2%(P<0.05)。MoCA认知筛查的灵敏度最高(98.8%),MMSE认知筛查的特异度最高(91.6%),与其他量表相比均存在统计学差异。与CDT-Royall相比,CDT-Lin评分系统认知筛查的灵敏度较高,但特异度较低(P<0.01)。结论将简单评分系统CDT与MMSE量表联合用于煤矿地区老年人早期认知筛查,并在认知障碍诊断中联合MoCA量表,以提高认知筛查和诊断的灵敏度、特异度和准确度。Objective To explore the efficacy of different scoring systems of clock drawing test(CDT),mini-mental state examination(MMSE)and montreal cognitive assessment(MoCA)in screening cognitive impairment in the elderly in coal mining area.Method 85 elderly patients with cognitive impairment and 95 elderly with normal cognitive function were recruited from the coal mining area of Datong city.The scoring system of CDT-Lin,CDT-Royall,MMSE and MoCA were used to quantitatively evaluate the cognitive function of the elderly in the two groups.The basic information and the cognitive scores were compared between the two groups.The receiver operating characteristic cure(ROC cure)of the cognitive screening scales was drawn.The sensitivity and specificity of cognitive screening were compared among different scales.Results There were no significant differences in sex,age,years of education,body mass index,smoking and drinking status,social activities,physical exercise and living alone between the two groups.The cognitive scores of CDT-Lin,CDT-Royall,MMSE and MoCA in the cognitive impairment group were significantly lower than those in the normal cognitive function group.The areas under the curves of cognitive screening using CDT-Lin,CDTRoyall,MMSE and MoCA were 60.1%,62.3%,80.5%and 86.2%,respectively(P<0.05).The sensitivity of cognitive screening using MoCA was the highest(98.8%),and the specificity of cognitive screening using MMSE was the highest(91.6%).Compared with other scales,significant differences were observed.Compared with CDT-Royall,CDT-Lin scoring system had higher sensitivity but lower specificity in cognitive screening(P<0.01).Conclusion In order to improve the sensitivity,specificity and accuracy of cognitive screening and diagnosis,the simple scoring system CDT combined with MMSE were used in the early cognitive screening of the elderly in the coal mine mining area,and the MoCA was also used in the diagnosis of cognitive impairment in order to improve the sensitivity,specificity and accuracy of cognitive screening a

关 键 词：画钟测验 简易精神状态检查量表 蒙特利尔认知评估量表 认知筛查 

分 类 号：R395.1[哲学宗教—心理学]