海南版简易智能状态检查量表和蒙特利尔认知评估量表界值划分的初步研究

目的初步探讨中文海南版(琼北闽语版)简易智能状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评分在本地人群认知筛查中的可行性及界值的划分。方法选取2019年1~9月海口市养老院和海南省人民医院门诊及住院的本地被试者217例,根据临床诊断分为正常组45例,轻度认知功能障碍(MCI)组54例,轻度痴呆组62例,中度以上痴呆组56例,同时进行MMSE及MoCA评分评估,进行两种量表评分相关性及界值。结果与正常组比较,MCI组、轻度痴呆组和中度以上痴呆组MMSE及MoCA评分明显降低,差异有统计学意义(P<0.05)。正常组、MCI组、轻度痴呆组和中度以上痴呆组MMSE评分明显高于MoCA评分(P<0.01)。Person相关分析显示,MMSE评分与MoCA评分呈正相关(r=0.940,P<0.01)。MCI组、轻度痴呆组和中度以上痴呆组ROC曲线界值为:MCI组MMSE评分低于27分,MoCA评分低于22分;轻度痴呆组MMSE评分低于23分,MoCA评分低于16分;中度以上痴呆组MMSE评分低于15分,MoCA评分低于11分。结论海南版(琼北闽语版)MMSE与MoCA评分有较好的一致性,联合应用对认知障碍及痴呆患者有较好的筛查应用价值。

Cut-off point of Chinese Hainan version of MMSE scale and MoCA scale

Objective To study the feasibility and cut-off point of Chinese Hainan version of MMSE scale and MoCA scale in screening cognitive function of Hainan local people.Methods Two hundred and seventeen Hainan local patients who visited the Outpatient Department or admitted to our hospital were divided into normal cognitive function group(n=45),mild cognitive impirement(MCI)group(n=54),mild dementia(MD)group(n=62)and≥MD group(n=56).The patients were scored according to the MMSE scale and MoCA scale.The correlation of MMSE scale and MoCA scale with their cut-off point was analyzed.Results The MMSE scale and MoCA scale scores were significantly lower in MCI group,MD group and≥MD group than in normal cognitive function group(P<0.05).The MMSE scale score was significantly higher than the MoCA scale score in normal cognitive function group,MCI group,MD group and≥MD group(P<0.01).Person correlation analysis showed that the MMSE scale score was positively related with the MoCA scale score(r=0.940,P<0.01).ROC curve analysis showed that the MMSE scale score was<27 and the MoCA scale score was<22 in MCI group,the MMSE scale score was<23 and the MoCA scale score was<16 in MD group,the MMSE scale score was<15 and the MoCA scale score was<11 in≥MD group.Conclusion The consistency of Chinese Hainan version of MMSE scale score and MoCA scale score is rather good.MMSE scale combined with MoCA scale can effectively sreen cognitive impairment and dementia in Hainan local people.