Comparison of two commonly used clinical cognitive screening tests to diagnose mild cognitive impairment in heart failure with the golden standard European Consortium Criteria
Comparison of two commonly used clinical cognitive screening tests to diagnose mild cognitive impairment in heart failure with the golden standard European Consortium Criteria
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DOI：
10.1016/j.ijcard.2016.11.193
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发表时间：
2017-02-01
影响因子：
3.5
通讯作者：
Ezekowitz, Justin
中科院分区：
文献类型：
--
作者：
Alagiakrishnan, Kannayiram;Mah, Darren;Ezekowitz, Justin
导读：这项关于心力衰竭患者轻度认知障碍（MCI）的研究比较了蒙特利尔认知评估（MoCA）和迷你精神状态检查（MMSE）在诊断心力衰竭患者MCI方面的应用，并与黄金标准欧洲联盟标准（ECC）进行了比较。方法：参与者从埃德蒙顿马赞科夫斯基阿尔伯塔心脏研究所和卡姆罗斯圣玛丽医院的阿尔伯塔心脏研究中招募。这项研究招募了53名年龄在50岁至50岁之间的社区成年人：33名HF和20名对照组。使用MMSE和MoCA对参与者进行MCI评估。MCI的诊断采用黄金标准，即欧洲联盟标准。计算敏感性和特异性分析、阳性和阴性预测值、似然比和kappa统计量。结果：平均年龄72.8岁（SD 8.4）， 60.4%为女性，34%患有缺血性心脏病。总体而言，三分之二的HF患者（22/ 33,66%）患有MCI。与欧洲联盟标准相比，MoCA识别MCI个体的敏感性和特异性分别为82%和91%，MMSE分别为9%和91%。MoCA阳性预测值和阴性预测值分别为95%和71%，MMSE阳性预测值分别为67%和33%。Kappa统计显示MoCA与联盟标准的一致性较好（Kappa = 0.68）， MMSE与联盟标准的一致性较低（Kappa = 0.07）。结论：心衰患者普遍存在认知功能障碍。总的来说，MoCA似乎是一种比MMSE更好的心衰患者MCI筛查工具。2016爱思唯尔爱尔兰有限公司版权所有。
Introduction: This study on mild cognitive impairment (MCI) in heart failure (HF) compares the utility of Montreal Cognitive Assessment (MoCA) to the Mini-Mental Status Exam (MMSE) for diagnosing MCI in a HF population when compared to the golden standard European Consortium Criteria (ECC).Methods: Participants were recruited from the Alberta HEART study at the Mazankowski Alberta Heart Institute in Edmonton and St. Mary's hospital in Camrose. This study enrolled 53 community adults aged > 50 years: 33 HF and 20 controls. Participants were assessed using both the MMSE and MoCA for MCI. MCI was diagnosed using the golden standard, European Consortium Criteria. Sensitivity and specificity analysis, positive and negative predictive values, likelihood ratios and kappa statistic were calculated.Results: The mean age was 72.8 years (SD 8.4), 60.4% were females and 34% had underlying ischemic heart disease. Overall, two thirds of patients (22/33, 66%) with HF had MCI. In comparison to European Consortium Criteria, the sensitivity and specificity of MoCA were 82% and 91% in identifying individuals with MCI, and MMSE were 9% and 91%, respectively. The positive and negative predictive values for MoCA were 95% and 71%, and for MMSE were 67% and 33%, respectively. Kappa statistics showed good agreement between MoCA and consortium criteria (kappa = 0.68) and a low agreement between MMSE and consortium criteria (kappa = 0.07).Conclusion: Cognitive dysfunction is common in patients with HF. Overall, the MoCA seems to be a better screening tool than MMSE for MCI in HF patients. (C) 2016 Elsevier Ireland Ltd. All rights reserved.