言语流畅性测验在痴呆识别和鉴别诊断中的应用

目的:评价超市物品言语流畅性测验识别早期痴呆的效力。方法:正常对照242例,阿尔茨海默病276例,血管性痴呆41例,接受MMSE、言语流畅性(VFT)、临床痴呆量表检查。VFT指标有正确总数、串联长度及转换数。结果:不同教育划界分识别轻度AD的敏感度、特异度依次为:0-6年,11,56.5%,72.5%;7-12年,12,75.0%,72.9%;12年 ,13,83.1%,78.4%;对照组言语流畅性成绩与增龄呈负相关、与教育呈正相关;AD组与增龄无关,与教育关联程度明显减低;串联长度对VFT总分贡献高于转换次数;痴呆严重程度相同的VaD患者言语流畅性各项得分均显著低于AD组,类别转换的减少程度(P=0.003)较串联长度(p=0.011)更为明显。结论:超市物品言语流畅性测验识别轻度AD敏感性、特异性高。该测验反映多个认知领域,串联、转换等因子分对痴呆的鉴别诊断具有一定价值。

Supermarket Verbal Fluency Test in Identification and Differential Diagnosis of Dementia

Objective: To evaluate sensitivity and specificity of supermarket verbal fluency test(VFT) in identifying mild Alzheimer's disease(AD). Methods: 267 AD,242 control(NC),41 vascular dementia(VaD) patients received mini-mental status examination(MMSE),supermarket VFT,clinical dementia rating(CDR) scale. Two components-clustering (generating words within subcategories) and switching (shifting between subcategories) were examined. Results: Cutoff scores for different educational level and corresponding sensitivity and specificity for identifying mild AD were: 0-6yrs, 11, 56.5%, 72.5%; 7-12yrs, 12, 75.0%, 72.9% and 12 yrs, 13, 83.1%, 78.4%. Age and education correlated well with VFT performance in NC. AD weakened this correlation. Both clustering and switching contributed to total scores, while the latter seemed more important. VaD group showed significant lower scores in all VFT items than AD patients. Switching decreased more strikingly than clustering. Conclusion: Supermarket VFT is an effective neuropsychological test in dementia screening. Analysis of clustering and switching may be helpful to differential diagnosis of dementia.