军队体检人群应用两种量表筛查认知功能障碍的临床研究

目的探讨联合应用AD8和简易智力状态评估量表(Mini-Cog)在军队体检人群筛查认知功能障碍的特异性和敏感性。方法纳入我院常规健康体检军队人群1723例,对自愿接受认知功能测评者行AD8量表和Mini-Cog测评,最终同时接受AD8量表和Mini-Cog检测的体检者160例。采用ROC曲线分析量表评估的敏感性、特异性,计算ROC曲线下面积(AUC)。结果AD8量表和Mini-Cog测评提示认知功能障碍者分别为84例(52.5%)和71例(44.4%),两者联合检测提示双异常者为43例(26.9%)。160例受检者中临床诊断为认知功能障碍者66例(41.3%),其中AD8量表检出率为69.7%,Mini-Cog检出率为83.3%,两者联合检出率为56.1%。ROC曲线分析显示,两者联合检测特异性为93.6%,敏感性为56.1%。AD8(≥2分)量表、Mini-Cog及两者联合检测评估认知功能障碍的AUC比较,差异有统计学意义(P<0.01)。与认知正常者比较,双异常者年龄明显增高(P<0.01),在调整年龄的影响因素后,协方差分析显示,双异常者连线A完成时间明显延长,简易智能状态检查量表、延迟回忆、执行功能、工作记忆、词语流畅性评分明显降低(P<0.01)。结论AD8和Mini-Cog操作简单,测评所需时间短,两者联合检测可明显提高痴呆患者检出的特异性,适用于在初级医疗卫生保健机构筛查认知功能障碍患者。

Application of AD8 scale combined with Mini-Cog scale in screening cognitive impairment during physical examination of servicemen

Objective To study the specificity and sensitivity of AD8 scale combined with Mini-Cog scale in screening cognitive impairment during physical examination of servicemen.Methods Of the 1723 servicemen who underwent physical examination in our hospital,160 underwent both AD8 scale and Mini-Cog scale examination for assessing their cognitive impairment.The specificity and sensitivity of AD8 scale combined with Mini-Cog scale for assessing their cognitive impairment were analyzed by ROC curve analysis.The area under the ROC curve for cognitive impairment was measured.Results The AD8 scale and Mini-Cog scale showed cognitive impairment in 84(52.5%),71(44.4%)and 43 servicemen(26.9%)respectively.Of the 160 servicemen,66(41.3%)were diagnosed with cognitive impairment.The detection rate of cognitive impairment by AD8 scale,Mini-Cog scale and AD8 scale combined with Mini-Cog scale was 69.7%,83.3%and 56.1%respectively.ROC curve analysis showed that the specificity and sensitivity of AD8 scale combined with Mini-Cog scale for detecting cognitive impairment were 93.6%and 56.1%respectively.A significant difference was detected in the area under the ROC curve for AD patients with cognitive impairment according to the AD8 scale≥2,Mini-Cog scale and AD8 combined with Mini-Cog scale(P>0.05).The age was significantly older in AD patients with abnormal AD8 scale and Mini-Cog scale score of cognitive function than in those with normal AD8 scale and Mini-Cog scale score of cognitive function(P<0.01).Convariance analysis showed that the linear A completion time was significantly longer,the scores of Mini-Cog scale,delayed memory,executive performance,working memory and speech fluence were significantly lower in AD patient with abnormal AD8 scale and Mini-Cog scale score of cognitive function than in those with normal AD8 scale and Mini-Cog scale score of cognitive function after adjustment for age(P<0.01).Conclusion AD8 scale and Mini-cog scale are simple to operate and their time to assess the cognitive function in AD patients is short.AD8 scale combined with Mini-Cog scale can significantly improve the specificity of screening dementia patients and can thus be used in screening cognitive impairment in primary healthcare institutions.