The MMSE and MoCA for Screening Cognitive Impairment in Less Educated Patients with Parkinson's Disease.
The MMSE and MoCA for Screening Cognitive Impairment in Less Educated Patients with Parkinson's Disease.
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DOI：
10.14802/jmd.16020
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发表时间：
2016-09
影响因子：
3.9
通讯作者：
Hong JY
中科院分区：
文献类型：
--
作者：
Kim JI;Sunwoo MK;Sohn YH;Lee PH;Hong JY
目的：探讨简易智力状态检查(MMSE)和蒙特利尔认知评估(MoCA)能否用于筛查低学历帕金森病(PD)患者的痴呆或轻度认知功能障碍(MCI)。我们回顾了接受韩国MMSE(K-MMSE)、韩国MoCA(K-MoCA)和综合神经心理测试的PD患者的病历。按文化程度分组分析K-MMSE和K-MoCA对痴呆或MCI的预测价值。K-MMSE和K-MoCA对痴呆的鉴别能力较好[曲线下面积(AUC)0.86~0.97]，但对MCI的鉴别能力较差(AUC为0.64~0.85)。两种测试的最佳筛查值均随受教育程度的增加而增加(文盲15分，受教育0.5~3年20分，4~6年23分，7~9年25分，10年及以上26分；文盲7分，0.5~3年13分，4~6年19分，7~9年19分；文盲(K-MMSE<；19为文盲，26为0.5-3年，<；27为4-6年，<；28为7-9年，<；29为10年或以上；K-MoCA<；13为文盲，<；21为0.5-3年，<；23为4-6年，<；25为7-9年，<；26为10年或以上)。无论受教育程度如何，MMSE和MoCA都可以用来筛查帕金森病患者的痴呆症；然而，在没有额外信息的情况下，这两种测试都不足以区分MCI和正常认知。
To explore whether the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) can be used to screen for dementia or mild cognitive impairment (MCI) in less educated patients with Parkinson’s disease (PD). We reviewed the medical records of PD patients who had taken the Korean MMSE (K-MMSE), Korean MoCA (K-MoCA), and comprehensive neuropsychological tests. Predictive values of the K-MMSE and K-MoCA for dementia or MCI were analyzed in groups divided by educational level. The discriminative powers of the K-MMSE and K-MoCA were excellent [area under the curve (AUC) 0.86–0.97] for detecting dementia but not for detecting MCI (AUC 0.64–0.85). The optimal screening cutoff values of both tests increased with educational level for dementia (K-MMSE < 15 for illiterate, < 20 for 0.5–3 years of education, < 23 for 4–6 years, < 25 for 7–9 years, and < 26 for 10 years or more; K-MoCA < 7 for illiterate, < 13 for 0.5–3 years, < 16 for 4–6 years, < 19 for 7–9 years, < 20 for 10 years or more) and MCI (K-MMSE < 19 for illiterate, < 26 for 0.5–3 years, < 27 for 4–6 years, < 28 for 7–9 years, and < 29 for 10 years or more; K-MoCA < 13 for illiterate, < 21 for 0.5–3 years, < 23 for 4–6 years, < 25 for 7–9 years, < 26 for 10 years or more). Both MMSE and MoCA can be used to screen for dementia in patients with PD, regardless of educational level; however, neither test is sufficient to discriminate MCI from normal cognition without additional information.