Objective: The present retrospective study was to explore the clinical value of Six-Item Screener (SIS), which is constituted by 6 items from mini-mental status examination (MMSE), to identify cognitive impairment.
Methods: A total number of 1976 patients aged over 50 years, from the Memory Clinic of Huashan Hospital were employed in a battery of neuropsychological tests including MMSE. Subjects with severe conditions, unable to cooperate, or having been previously enrolled, were excluded from this study. The employed subjects were divided into 3 groups: subjective memory complaints (SMCs) (475 cases), patients with mild cognitive impairment (MCI) (440 cases), and patients with Alzheimer's disease (AD) (1061 cases, including 555 mild, 339 moderate, and 167 severe). A total score of MMSE and a score of SIS composed of date, month, year, three-word delayed recall from MMSE were calculated. Data were analyzed based on educational background.
Results: The cut-off of SIS score was <2 for illiterate, <3 for elementary, and <4 for junior high school or above. The sensitivity and specificity of SIS for detecting mild AD were 88.5% and 78.3%, respectively, with an overall accuracy of 83.8%, while for detecting MCI, the sensitivity and specificity were 34.3% and 90.1%, respectively, with an overall accuracy of 63.2%.
Conclusion: SIS is an effective and reliable instrument for dementia detection in outpatient department. However, it has limited value for MCI identification.
目的: 评价简易精神状态检查表(mini-mental status examination, MMSE)中时间定向与词语延迟回忆得分组成的六分法(Six-Item Screener, SIS)在识别认知损害中的价值。
方法: 在华山医院神经内科记忆障碍门诊部的1976例就诊者中, 根据轻度认知损害(mild cognitive impairment, MCI)和痴呆的诊断标准分为认知功能正常的主观抱怨者(475 例)、 MCI 患者(440 例)和阿尔茨海默病(Alzheimer’s disease, AD)患者(共1061 例, 其中轻度AD 555 例、 中度AD 339 例、 重度AD 167 例)。 所有就诊者完成包括MMSE 在内的全套神经心理测验。 分析MMSE 中年份、 月份、 日期以及三个词语延迟回忆(简称三词)的总得分(共6分)在区分不同程度的认知障碍中的作用。
结果: SIS总分以文 盲组⩽ 2 分、 小学组⩽ 3 分、 初中及以上组⩽ 4 分作为划界分, 其识别轻度AD的敏感性为88.5%、 特异性为78.3%、 准确性为83.8%, 识别MCI 的敏感性为34.3%、 特异性为90.1%、 准确性为63.2%。
结论: 六分法对于门急诊快速识别痴呆具有一定的价值, 但不适用于识别MCI。