记忆与执行筛查量表北京常模的初步探讨  

Preliminary study on Beijing norm of Memory and Executive Screening scale

作　　者：郝立晓[1] 贾建国[1] 曹若瑾[2] 魏占云[2] 王紫晨[2] 张仲迎[2] 韩璎[3] Hao Lixiao;Jia Jianguo;Cao Ruojin;Wei Zhanyun;Wang Zichen;Zhang Zhongying;Han Ying(Department of General Practice,Xuanwu Hospital of Capital Medical University,Beijing 100053,China;Department of Geriatrics,Xuanwu Hospital of Capital Medical University,Beijing 100053,China;Department of Neurology,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院全科医学科,北京100053 [2]首都医科大学宣武医院老年科,北京100053 [3]首都医科大学宣武医院神经内科,北京100053

出　　处：《中华神经科杂志》2022年第5期452-457,共6页Chinese Journal of Neurology

摘　　要：目的制定记忆与执行筛查量表(MES)的北京常模,利于后期该量表的进一步推广、应用。方法依据纳入和排除标准,选择2017年3月20日至2021年1月6日在首都医科大学宣武医院记忆门诊就诊的患者以及社区招募的正常人作为研究对象,由培训合格的调研员通过面对面询问的方式开展问卷调查,严格质量控制,收集数据并进行统计学分析。结果共纳入607人,其中认知正常239人,主观认知下降(SCD)293人,轻度认知障碍(MCI)75人。MES得分和年龄呈负相关(r=-0.19,P<0.001),和受教育程度呈正相关(r=0.29,P<0.001)。北京地区该量表的最佳截断值为86分,该截断值区分MCI的曲线下面积(AUC)分别为0.847(认知正常比MCI)和0.826(SCD比MCI),而当加入人口学因素后,AUC出现了轻度增大(0.847增至0.850及0.826增至0.847),但差异无统计学意义(Z认知正常比MCI=0.49,ZSCD比MCI=1.21,均P>0.05)。MES和蒙特利尔认知评估量表相比,对MCI的诊断效力差异亦无统计学意义(Z单量表=1.03,Z加入人口学因素后=1.13,均P>0.05)。结论MES对于MCI的识别有较好的区分效力。北京地区MES最佳截断值为86分,不同于既往研究。未来需进一步扩大样本量去验证该常模。Objective To develop a Beijing norm of Memory and Executive Screening(MES)scale to facilitate its further promotion and application in the future.Methods Study subjects were selected based on the inclusion and exclusion criteria,including patients who visited the memory clinic of Xuanwu Hospital of Capital Medical University from March 20,2017 to January 6,2021,and normal people recruited simultaneously from community,and trained and qualified investigators conducted questionnaire surveys through face-to-face interviews.Then strict quality control,data collection and statistical analysis were performed.Results A total of 607 participants were included,including 239 normal people,293 individuals with subjective cognitive decline(SCD),and 75 individuals with mild cognitive impairment(MCI).There was a negative correlation between the scores of MES and age(r=-0.19,P<0.001),but a positive correlation between scores of MES and education level(r=0.29,P<0.001).The optimal cut-off value of this scale in Beijing was 86 points,the area under curve(AUC)of the cut-off value to distinguish MCI was 0.847(normal people vs MCI)and 0.826(SCD vs MCI),and after adding demographic variables,AUC showed slight increase(0.847 to 0.850 and 0.826 to 0.847),whereas the differences were not statistically significant(Znormal peoplevs MCI=0.49,ZSCD vs MCI=1.21,P>0.05).And there was no statistically significant difference between MES and Montreal Cognitive Assessment scales in diagnostic power for normal people and people with MCI(Zscale alone=1.03,Zafter adding demographic variables=1.13,P>0.05).Conclusions The MES scale has a better distinguishing power for MCI,and its optimal cut-off value in Beijing is 86 points,which is different from previous studies.In the future,the sample size needs to be further expanded to verify this norm.

关 键 词：阿尔茨海默病 轻度认知障碍 主观认知下降 记忆与执行筛查量表 

分 类 号：R749.1[医药卫生—神经病学与精神病学]