初级保健人群认知评估的准确性

IF 1.4 Q4 CLINICAL NEUROLOGY Dementia and Geriatric Cognitive Disorders Extra Pub Date : 2019-08-14 DOI:10.1159/000501365
A. S. Kvitting, Maria M. Johansson, J. Marcusson
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引用次数: 2

摘要

背景:在初级保健中有几种认知评估工具,如简易精神状态检查(MMSE)和蒙特利尔认知评估。认知评估电池(CAB)被引入作为一种敏感的工具来检测初级保健的认知能力下降。然而,缺乏初级保健验证。因此,我们在初级保健人群中调查了CAB的准确性。目的:探讨初级保健人群CAB的准确性。方法:对46例认知障碍患者和33例因躯体非认知症状就诊的初级保健患者的资料进行分析。他们接受了MMSE、CAB和一系列神经心理学测试的调查;他们还接受了老年专家的咨询。使用c-statistics评估CAB的准确性,并使用受试者工作特征曲线下面积(AUC)量化二元结果(“无认知障碍”或“认知障碍”)。结果:认知障碍组与非认知障碍组在CAB各子测试上均有显著性差异。当精度基于CAB的一个或几个域的二进制显著降低或不显著降低时,AUC在0.685和0.772之间变化。然而,当对几个子类别进行求和或逻辑回归时,使用每个子类别的数值,AUC为>0.9。相比之下,MMSE的AUC为0.849。结论:在初级保健人群中,当使用二元截止时,CAB的准确性从差到好。当使用子类别的数值数据的总和或逻辑回归时,精度可以提高到很高。考虑到CAB的时间,缺乏足够的年龄规范,以及MMSE的良好准确性,根据本研究的结果,目前不建议在初级保健中实施CAB。
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Accuracy of the Cognitive Assessment Battery in a Primary Care Population
Background: There are several cognitive assessment tools used in primary care, e.g., the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment. The Cognitive Assessment Battery (CAB) was introduced as a sensitive tool to detect cognitive decline in primary care. However, primary care validation is lacking. Therefore, we investigated the accuracy of the CAB in a primary care population. Objective: To investigate the accuracy of the CAB in a primary care population. Methods: Data from 46 individuals with cognitive impairment and 33 individuals who visited the primary care with somatic noncognitive symptoms were analyzed. They were investigated with the MMSE, the CAB, and a battery of neuropsychological tests; they also underwent consultation with a geriatric specialist. The accuracy of the CAB was assessed using c-statistics and the area under the receiver operating characteristic curve (AUC) was used to quantify the binary outcomes (“no cognitive impairment” or “cognitive impairment”). Results: The “cognitive impairment” group was significantly different from the unimpaired group for all the subtests of the CAB. When accuracy was based on binary significant reduction or not in one or several domains of the CAB, the AUC varied between 0.685 and 0.772. However, when a summation or logistic regression of several subcategories was performed, using the numerical values for each subcategory, the AUC was >0.9. For comparison, the AUC for the MMSE was 0.849. Conclusions: The accuracy of the CAB in a primary care population is poor to good when using binary cutoffs. Accuracy can be improved to high when using a summation or logistic regression of the numerical data of the subcategories. Considering CAB time, lack of adequate age norms, and a good accuracy for the MMSE, implementation of the CAB in primary care is not recommended at present based on the results of this study.
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来源期刊
Dementia and Geriatric Cognitive Disorders Extra
Dementia and Geriatric Cognitive Disorders Extra Medicine-Psychiatry and Mental Health
CiteScore
4.30
自引率
0.00%
发文量
18
审稿时长
9 weeks
期刊介绍: This open access and online-only journal publishes original articles covering the entire spectrum of cognitive dysfunction such as Alzheimer’s and Parkinson’s disease, Huntington’s chorea and other neurodegenerative diseases. The journal draws from diverse related research disciplines such as psychogeriatrics, neuropsychology, clinical neurology, morphology, physiology, genetic molecular biology, pathology, biochemistry, immunology, pharmacology and pharmaceutics. Strong emphasis is placed on the publication of research findings from animal studies which are complemented by clinical and therapeutic experience to give an overall appreciation of the field. Dementia and Geriatric Cognitive Disorders Extra provides additional contents based on reviewed and accepted submissions to the main journal Dementia and Geriatric Cognitive Disorders Extra .
期刊最新文献
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