中国医学科学院学报2025，Vol.47Issue(3)：382-389,8.DOI:10.3881/j.issn.1000-503X.16242
简短版蒙特利尔认知评估量表在社区中老年人群中判别认知障碍的有效性及成本结果分析
Validity and Cost-Consequence Analysis of the Brief Version of the Montreal Cognitive Assessment for Discriminating Cognitive Impairment in a Community-Based Middle-Aged and Elderly Population
摘要
Abstract
Objective To evaluate the reliability and validity and perform cost-consequence analysis of the brief version of the Montreal cognitive assessment(MoCA)for identifying cognitive impairment in a commu-nity-based population ≥50 years of age.Methods The internal consistency and retest reliability of the brief ver-sion of the MoCA were analyzed,and the area under the curve(AUC),sensitivity,and specificity were deter-mined to discriminate mild cognitive impairment(MCI)and dementia with the clinical dementia rating(CDR)as the diagnostic criterion.The consistency between the brief version and the full version was analyzed by the Kappa test and the Bland-Altman method,and the number of individuals entering the diagnostic assessment and the overall assessment time were estimated and compared between the two versions.Results A total of 303 individu-als were included in this study,of whom 192,94,and 17 had normal cognitive function,MCI,and dementia,respectively.The Cronbach's α and re-test coefficients of the brief version of MoCA were 0.754 and 0.711(P＜0.001),respectively.The brief version showed the AUC,sensitivity,and specificity of 0.889,74.5％,and 93.8％for identifying MCI,and 0.994,100％,and 93.8％for identifying dementia,respectively.When the brief version of MoCA was used to identify 94 patients with MCI in 303 individuals,107 individuals required additional diagnostic assessment,with an overall assessment time of 142.4 h,which represented decreases of 21.3％and 32.7％,respectively,compared with those of the full version.When the brief version of MoCA was used to identify 17 patients with dementia in 303 individuals,35 individuals required additional diagnostic assessment,with an overall assessment time of 70.4 h,a decrease of 29.5％in the time cost compared with the full version.Conclusions The brief version of MoCA can identify cognitively impaired individuals in a communi-ty-based middle-aged and elderly population,with diagnostic validity comparable to that of the full version but less time cost and fewer individuals needing additional diagnostic assessment to detect true-positive cases.It could be expanded for use in the community-based primary screening setting.关键词
认知障碍/简短版蒙特利尔认知评估量表/信度/判别效度/成本结果Key words
cognitive impairment/the brief version of the Montreal cognitive assessment/reliability/discriminant validity/cost-consequences分类
医药卫生引用本文复制引用
庞婷,张亚萍,陈仁伟,马爱举,余筱艺,黄诣雯,卢怡莼,徐欣..简短版蒙特利尔认知评估量表在社区中老年人群中判别认知障碍的有效性及成本结果分析[J].中国医学科学院学报,2025,47(3):382-389,8.基金项目
国家自然科学基金面上项目(72274170) （72274170）
