蒙特利尔认知评估量表筛查轻度认知功能障碍分界值的研究

目的研究蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)在筛查轻度认知功能障碍(MCI)中的应用价值,初步探讨MoCA筛查MCI的最佳界值。方法分别采用简易智能状态检查量表(MMSE)及MoCA评估入组的男性患者153例,根据诊断标准分为对照组69例、MCI组60例、AD组24例。进行2种量表得分的相关性分析,并且计算MoCA筛查MCI患者的敏感性、特异性、Kappa值、约登指数等,并选取最佳分界值。结果与对照组比较,MCI组和AD组MMSE评分和MoCA评分明显降低(P<0.05)。MMSE评分与MoCA评分呈正相关(r=0.847,P<0.01);以26分为分界值,MoCA诊断MCI的敏感性为98.3%,特异性为85.5%,Kappa值=0.830;绘制ROC曲线得到MoCA筛查MCI的最佳分界值为25分,敏感性为93.3%,特异性为97.1%,Kappa值=0.906。结论本研究人群MMSE评分与MoCA评分有很好的相关性,并且与临床诊断一致性好,推荐25分为该类人群MCI的分界值。

Application of Montreal cognitive assessment cut-off in screening mild cognitive impairment

Objective To study the application of Montreal cognitive assessment(MoCA) in screening mild cognitive impairment(MCI) and its optimal cut-off value.Methods One hundred and fifty -three MCI patients were divided into control group(n= 69),MCI group(n= 60),and Alzheimer's disease(AD) group(n= 24) according to its diagnostic criteria and evaluated using MoCA and mini-mental state examination(MMSE).Correlation between the MoCA and MMSE scores for the patients was analyzed.Sensitivity,specificity,Kappa value and Youden index of MoCA in screening MCI patients were calculated to select its optimal cut-off value.Results The MMSE and MoCA scores were significantly lower in MCI and AD groups than in control group(P< 0.05).The MMSE score was closely related with the MoCA score(r=0.847,P<0.01).The sensitivity, specificity and Kappa value of MoCA for the diagnosis of MCI were 98.3%,85.5%and 0.830 respectively when its cut-off value was 26.ROC curve showed that the sensitivity,specificity and Kappa value of MoCA for the diagnosis of MCI were 93.3%,97.1%and 0.906 when its cut-off value was 25.Conclusion MMSE and MoCA scores are closely related in MCI patients and consistent with their clinical diagnosis.The cut-off value of MoCA at 25 is recommended for the diagnosis of MCI.