|国家科技期刊平台
首页|期刊导航|康复学报|全科医生认知功能评估量表患者测试在社区老年轻度认知障碍筛查中的应用

全科医生认知功能评估量表患者测试在社区老年轻度认知障碍筛查中的应用OACSTPCD

Application of Patient Version of General Practitioner Assessment of Cognition for Screening Elderly with Mild Cognitive Impairment in Community

中文摘要英文摘要

目的 探讨全科医生认知功能评估量表患者测试(P-GPCOG)在社区老年轻度认知障碍(MCI)筛查中的适用价值.方法 选择2022年4月—2023年11月四川大学华西天府医院、崇州二医院招募的老年受试者905例,其中认知功能正常组(NC组)627例、MCI组278例.采用P-GPCOG、蒙特利尔认知评估量表(MoCA)、AD8痴呆筛查面谈(AD8)评分评估受试者认知功能;采用Lawton工具性日常生活活动能力量表(Lawton-IADLs)评估受试者日常生活活动能力独立性;采用老年人抑郁量表简表(GDS-15)评估受试者抑郁情况.绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC)、灵敏度、特异度、阳性预测值和阴性预测值评价GPCOG患者测试筛查应用价值.结果 与NC组比较,MCI组MoCA、Lawton-IADLs评分均明显更低(P<0.001,P=0.022);AD8、GDS-15评分均明显更高(P<0.001);2组P-GPCOG评分差异具有统计学意义(Z=15.001,P<0.001).与NC组比较,MCI组时间定位、画钟测试、报告事件、延迟回忆测试项目正确率和测试总分均明显更低,差异具有统计学意义(P<0.001).MCI组认知领域损伤率从高到低排序依次是延迟回忆测试、画钟测试、时间定位和报告事件.P-GPCOG区分MCI患者ROC曲线下面积(AUC)为0.804[95%CI(0.773,0.836),P<0.001],其最佳截断值为7/8分,敏感度82.70%,特异度为72.60%,阳性预测值为57.20%,阴性预测值为90.40%.结论 GPCOG患者测试是一个较好的社区认知筛查工具,可用于筛查社区MCI患者,但需对其原有的计分标准进行改良,以提高筛查正确率.

Objective To explore the application value of the patient version of general practitioner assessment of cognition(P-GPCOG)for screening elderly with mild cognitive impairment(MCI)in community.Methods A total of 905 elderly were recruited from West China Tianfu Hospital,Sichuan University and Chongzhou Second Hospital from April 2022 to November 2023,including 627 cases in normal cognitive function group(NC group)and 278 cases in MCI group.The cognitive function of the subjects was evaluated by P-GPCOG,the Montreal Cognitive Assessment(MoCA),and the 8-item ascertain dementia(AD8).The independence of daily living ability was evaluated by the Lawton Instrumental Activities of Daily Living Scale(IADLs).The Geriat-ric Depression Scale-15(GDS-15)was used to assess the depressive symptoms of the subjects.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC),sensitivity,specificity,positive predictive value and negative predic-tive value were calculated to evaluate the application value of GPCOG screening.Results Compared with the NC group,the MoCA and Lawton-IADL scores were significantly lower in the MCI group(P<0.001,P=0.022).The AD8 and GDS-15 scores were significantly higher(P<0.001).There was a significant difference in the P-GPCOG scores between the two groups(Z=15.001,P<0.001).Compared with the NC group,correct rate of the time orientation,clock drawing,reporting events and delayed recall,and the total score were significantly lower in the MCI group,with statistically significant differences(P<0.001).In the MCI group,the order of cognitive impairment rate from high to low was delayed recall test,clock drawing test,time orientation and reporting events.AUC of P-GPCOG for differentiating MCI patients was 0.804[95%CI(0.773,0.836),P<0.001],with an optimal cutoff value of 7/8 points.The sensitivity was 82.7%,the specificity was 72.6%,the positive predictive value was 57.2%,and the negative predictive value was 90.4%.Conclusion The P-GPCOG is a good community-based cognitive screening tool for screening MCI patients in community,but its original scoring criteria needs to be refined to improve the correct screening rate.

杨挺;何佳丽;宋林林;刘文焘;桂尘璠;陈晓;徐利;贾程森

四川大学华西医院,四川 成都 610047||四川大学华西天府医院,四川 成都 610218崇州二医院,四川 成都 611230四川大学华西医院,四川 成都 610047

轻度认知障碍全科医生认知功能评估量表患者测试认知功能筛查灵敏度特异度

mild cognitive impairmentpatient version of general practitioner assessment of cognitioncognitive screeningsensitivityspecificity

《康复学报》 2024 (004)

377-382 / 6

国家重点研发计划项目(2022YFC3602603)

10.3724/SP.J.1329.2024.04010

评论