| 引用本文: | 付继平,陈安妮,陈洁芬,李艳,徐书雯.住院患者老年综合评估认知筛查量表应用的比较[J].中国临床新医学,0,():-. |
| Fujiping,CHEN An-ni,CHEN Jie-fen,LI Yan,XU Shu-wen.住院患者老年综合评估认知筛查量表应用的比较[J].中国临床新医学,0,():-. |
|
| 摘要: |
| 目的 比较MMSE、MoCA、Mini-cog及画钟试验（CDT）这四个量表在筛查老年住院患者认知功能受损的评估效能，旨在制定简单、易懂、适合中国住院老年患者的老年综合评估（CGA）量表。方法 采用CGA量表对广东省人民医院老年科病房2017-04～2018-08住院的75岁及以上老年患者进行评估，每位患者认知评估部分均采用MMSE、MoCA、Mini-cog及CDT量表，根据评估结果计算敏感度、特异度、kappa系数及约登指数，使用受试者工作特征曲线（ROC）确定曲线下面积（AUC）。结果 接受评估的225名患者中，认知受损为107人。MMSE筛查认知受损敏感度为0.76，特异度为0.93，约登指数为0.69；MoCA筛查认知受损敏感度为0.97，特异度为0.41，约登指数为0.38; Mini-cog筛查认知受损敏感度为0.72，特异度为0.79，约登指数为0.51；CDT筛查认知受损敏感度为0.64，特异度为0.74，约登指数为0.37。与实际认知状态相比，MMSE筛查认知受损的Kappa系数最高（0.695），其次为Mini-cog（0.509），MoCA最低（0.368）。结论 MMSE筛查认知受损的敏感度、特异度较高，真实性最大，与实际认知状态的一致性最好，其次为Mini-cog。因此对75岁及以上住院老年患者进行CGA时，可以选用MMSE筛查患者是否有认知受损，如若阳性，可对认知方面进一步进行评估。 |
| 关键词: 认知受损 老年综合评估 MMSE MoCA Mini-cog 画钟试验 老年人 |
| DOI： |
| 分类号: |
| 基金项目: |
|
| Comparison of the application of cognitive screening scales in geriatric comprehensive assessment of inpatients |
|
Fujiping,CHEN An-ni,CHEN Jie-fen,LI Yan,XU Shu-wen
|
|
Shantou University Medical College
|
| Abstract: |
| [Abstract] Objective This study was conducted to compare the efficacy of MMSE, MoCA, Mini-cog and CDT in screening cognitive impairment of elderly hospitalized patients, aiming to develop a convenient, understandable and appropriate comprehensive geriatric assessment (CGA) scale for elderly patients in China. Methods CGA scale was used to evaluate hospitalized patients aged 75 years or more in geriatric department of Guangdong provincial people’s hospital from April 2017 to August 2018. Each patient’s cognitive assessment part employed MMSE, MoCA, Mini-cog and CDT. Sensitivity, specificity, Kappa coefficient and Youden index were calculated based on the evaluation results. and the area under the curve (AUC) was determined by the receiver operating characteristic curve (ROC). Results Of the 225 patients evaluated, 107 were cognitively impaired. The sensitivity of MMSE in screening cognitive impairment was 0.76, the specificity was 0.93, the Youden index was 0.69. The sensitivity and specificity of MoCA screening cognitive impairment were 0.97, 0.41 respectively, and the Youden index was 0.38. The sensitivity of Mini-cog in screening cognitive impairment was 0.72, the specificity was 0.79, and the Youden index was 0.51. The sensitivity of CDT was 0.64, the specificity was 0.74 and the Youden index was 0.37. Compared with the actual cognitive status, the Kappa coefficient of MMSE screening cognitive impairment was the highest (0.695), followed by Mini-cog (0.509), and MoCA is the lowest (0.368). Conclusion MMSE has higher sensitivity, specificity, authenticity and better consistency compared with other cognition screening scales, followed by Mini-cog. Therefore, MMSE can be used to screen patients with cognitive impairment when performing CGA among patients aged 75 or above in hospital. If positive, cognition aspects can be further evaluated. |
| Key words: cognition impairment geriatric comprehensive assessment MMSE MoCa Mini-cog clock drawing test elderly people |
