轻度认知障碍高效认知筛查量表CQ-MCI的探索研究  

CQ-MCI:a potential effi cient cognitive screeningscale for mild cognitive impairment

作　　者：廖紫璇 李佳钰 刘一丹 黄述春 姜柳米 李小凤[1] Zixuan LIAO;Jiayu LI;Yidan LIU;Shuchun HUANG;Liumi JIANG;Xiaofeng LI(Neurology Department,Second Affi liated Hospital of Chongqing Medical University,Chongqing 400010,China;Chengdu Seventh People's Hospital,Chengdu 610000,China;Chongqing Ninth People's Hospital,Chongqing 400700,China)

机构地区：[1]重庆医科大学附属第二医院神经内科,重庆400010 [2]成都市第七人民医院,成都610000 [3]重庆市第九人民医院,重庆400700

出　　处：《阿尔茨海默病及相关病杂志》2025年第1期29-35,共7页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：重庆医科大学附属第二医院“宽仁英才”骨干项目(项目编号:2020-7-3-17);重庆市卫生健康委医学科研项目(项目编号:2023WSJK118)。

摘　　要：目的:轻度认知障碍(mild cognitive impairment,MCI)是众多临床工作者早期筛查识别的重要阶段,AD源性MCI是MCI主要类型,而单独的认知量表筛查MCI灵敏度和特异度不佳,全套神经心理学量表用于MCI筛查又耗时费力,故本文旨在基于既往使用的认知筛查量表,探索适用于中国人群的筛查AD源性MCI的高效量表。方法:所有受试者接受共27个认知筛查测验及临床痴呆评定量表(clinical Dementia Rating,CDR),最终纳入受试者242人,对照组121人(CDR=0),MCI组121人(CDR=0.5)。用spearman相关分析计算各测验Z值得分与CDR得分相关性,以显著相关的测验组成新的MCI筛查量表,并初步分析新量表的敏感度及特异度,确定新量表评分标准。结果:相关性分析结果显示,视觉认知评估测试(visual Cognitive Assessment Test,VCAT)-语言(r=-0.447,P<0.001)、VCAT-记忆(r=-0.717,P<0.001)、连线测试(trail making test,TMT)-B(r=0.426,P<0.001)、简易智能筛查量表(mini-mental state examination,MMSE)-定向力(r=-0.271,P=0.025)、MMSE-注意力(r=-0.313,P=0.009)、画钟试验(clock drawing test,CDT)(r=-0.407,P<0.001)与CDR得分相关性最佳,最终组成包含上述6个认知测验的新量表CQ-MCI,并设立了“可能的”(一个测验失败),“很可能的”(两个测验失败),“肯定的”(三个测试失败)MCI评定标准。结论:VCAT-语言、VCAT-记忆、TMT-B、MMSE-定向力、MMSE-注意力、CDT测验可以组成适用于中国人群的筛查AD源性MCI新量表CQ-MCI,将来需要在临床上进一步验证CQ-MCI的敏感性及可行性。Objective:Mild cognitive impairment(MCI)represents a crucial stage in the early diagnosis and intervention of dementia.MCI due to AD is the main type of MCI.Using a single cognitive screening scale for MCI has some shortcomings such as limited sensitivity and specifi city.Meanwhile,using a comprehensive neuropsychological battery for MCI screening is time consuming and laborintensive.Therefore,this study aims to explore an effi cient cognitive screening scale for Chinese population of MCI due to AD,based on previously used cognitive assessment tools.Methods:A total of 27 cognitive screening tests and the Clinical Dementia Rating(CDR)scale were administered to 242 participants:121 in the control group(CDR=0)and 121 in the MCI group(CDR=0.5).Spearman correlation analysis was used to assess the relationship between Z scores of each test and CDR scores.Tests showing signifi cant correlations were used to construct a new screening scale for MCI.Then conduct a preliminary analysis of the sensitivity and specifi city of the new scale,and establish the scoring criteria for the new scale.Results:The results of the correlation analysis showed that among the neuropsychological tests in various cognitive domains,Visual Cognitive Assessment Test(VCAT)-Language(r=-0.447,P<0.001),VCAT-Memory(r=-0.717,P<0.001),Trail Making Test(TMT)-B(r=0.426,P<0.001),Mini-Mental State Examination(MMSE)-Orientation(r=-0.271,P=0.025),MMSE-Attention(r=-0.313,P=0.009),and Clock Drawing Test(CDT)(r=-0.407,P<0.001)had the strongest correlations with CDR scores.These six cognitive tests were used to construct a new scale.And pass/fail criteria was derived that determined"possible"(one test failed),"probable"(two tests failed),and"defi nite"MCI(three tests failed).Conclusion:VCAT-Language;VCAT-Memory,TMT-B,MMSE-Orientation,MMSE-Attention,and CDT tests can be integrated to form a new screening scale for MCI suitable for the Chinese population of MCI due to AD.Further clinical validation is needed in the future to assess the sensitivity and feasibility o

关 键 词：轻度认知障碍 神经心理学量表 筛查量表 

分 类 号：R74[医药卫生—神经病学与精神病学]