Objective: To assess whether quick cognitive screening test (QCST) could quickly identify mild cognitive impairment (MCI).
Methods: QCST and a full set of standardized neuropsychological tests, including mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) were performed. A total number of 121 cases of MCI [41 cases of amnestic MCI-single domain (aMCI-s); 44 of amnestic MCI-multiple domain (aMCI-m); 36 of nonamnestic MCI (naMCI)], 79 cases of mild Alzheimer's disease (AD) and 186 healthy elderly volunteers were employed in the present study. All the participants (55-85 years old) had an educational level no less than 5 years. QCST subtests included word list recall, naming test, animal fluency test, similarity test, color trail-1min, clock drawing test, finger construction test, and digit span test. The total score of QCST was 90 points, 10 points for each index of subtests.
Results: The total scores of QCST in MCI, AD and the control groups were (58.13+/-8.18), (44.53+/-10.54) and (72.92+/-6.85) points, respectively. According to the educational level, the cut off scores of participants with an educational level of 5-8 years, 9-12 years and more than 13 years were 63, 65 and 68 points, respectively. The sensitivity and specificity of QCST in detection of MCI were 87.6% (85.7% for aMCI-s, 90.1% for aMCI-m and 89.5% for naMCI) and 84.3%, respectively. The area under the curve was 0.923 (95% CI: 0.892-0.953). Delayed memory, color trail-1min and similarity test could help distinguish between aMCI and naMCI.
Conclusion: QCST may have a good sensitivity and specificity for MCI detection, which warrants its further clinical application.
目的: 轻度认知损害(mild cognitive impairment, MCI)可根据认知表现分为遗忘型 MCI (aMCI)和非遗忘型MCI(naMCI)。 本研究旨在编制快速认知筛查测验(quick cognitive screening test, QCST)便于快速全面地识别MCI, 为进一步研究提供依据。
方法: 符合 MCI 操作性诊断标准的MCI 组121 例、 符合DSM-IV有关痴呆诊断标准的阿尔茨海默病(AD)组79 例和正常老年人组186 例, 参与了QCST 和标准化全套神经心理测验。 参与者教育程度均在5 年或以上, 年龄55–85 岁。 QCST 项目包括即刻记忆、 延迟回忆、 命名、 动物流畅性、 相似性、 彩色连线B、 画钟、 手指结构、 数字广度等9 个分测验, 每个分测验满分10 分, 总分90 分, 耗时10–15 分钟。
结果: MCI 组、 AD组和正常老年人组QCST总分分别为(58.13±8.18)、 (44.53±10.54)和(72.92±6.85)分。 制定教育程度在5–8年、 9–12 年、 高于13 年3 个组别的QCST 总分的划界分分别为63、 65 和68 分。 QCST 识别 MCI 的敏感性为87.6%, 其中识别aMCI-s、 aMCI-m 和naMCI 的敏感性分别为85.7%、 90.1% 和89.5%, 特异性均为84.3%。 曲线下面积为0.923 (95% CI: 0.892–0.953)。 延迟回忆、 连线和相似性均有助于区分aMCI 与naMCI。
结论: QCST 对MCI 具有较高的敏感性和特异性, 可在临床和流行病学调查方面进行推广应用。