A Virtual Supermarket Program for the Screening of Mild Cognitive Impairment in Older Adults: Diagnostic Accuracy Study.
A Virtual Supermarket Program for the Screening of Mild Cognitive Impairment in Older Adults: Diagnostic Accuracy Study.
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用于筛查老年人轻度认知障碍的虚拟超市项目：诊断准确性研究
DOI：
10.2196/30919
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发表时间：
2021-12-03
影响因子：
4
通讯作者：
Chen L
中科院分区：
文献类型：
--
作者：
Yan M;Yin H;Meng Q;Wang S;Ding Y;Li G;Wang C;Chen L
轻度认知障碍（MCI）通常是痴呆的前兆，MCI患者患痴呆的几率高于健康老年人。在轻度认知障碍阶段早期发现认知能力下降有助于更好地规划护理和干预措施。目前，使用虚拟现实（VR）筛查老年人轻度认知损伤是有希望的，但关于使用虚拟超市筛查轻度认知损伤的证据很少。本研究的目的是验证一种基于VR游戏的测试，即虚拟超市程序（VSP），用于区分轻度认知损伤患者和健康对照组，并确定不同年龄水平的临界值。研究对象是从中国长春的几家养老院和社区招募的。将患者分为健康对照组（n=64）和MCI组（n=62）。所有受试者均接受VSP和一系列神经心理检查。研究确定了VSP的最佳截止点、区分效度、并发效度和重测信度。我们用受试者工作特征曲线下面积（AUC）来评价鉴别效度，得到最佳截断值。采用Pearson相关分析评估并发效度，采用类内相关系数评估重测信度。整个样本的最佳临界值为46.4，区分MCI个体和健康对照的敏感性为85.9%，特异性为79.0%，AUC为0.870 （95% CI 0.799-0.924）。VSP评分中位指数为51.1（42.6 ~ 60.0）。VSP总分与精神状态检查总分有中度正相关（r=0.429， P< 0.001）。VSP总分与蒙特利尔认知评估评分呈正相关（r=0.645， P< 0.001）。VSP的重测信度是可行的（r=0.588， P= 0.048）。VSP对受试者来说是有趣和可行的。该方法对老年人MCI的鉴别具有较高的敏感性和特异性，是一种很有前景的筛查方法。VSP可以推广到其他国家的老年人，尽管可能需要一些文化适应。中国临床试验注册中心ChiCTR2000040074；https://www.chictr.org.cn/showprojen.aspx?proj=64639
Mild cognitive impairment (MCI) is often a precursor of dementia, and patients with MCI develop dementia at a higher rate than healthy older adults. Early detection of cognitive decline at the MCI stage supports better planning of care and interventions. At present, the use of virtual reality (VR) in screening for MCI in older adults is promising, but there is little evidence regarding the use of virtual supermarkets to screen for MCI. The objectives of this study are to validate a VR game–based test, namely, the Virtual Supermarket Program (VSP), for differentiating patients with MCI and healthy controls and to identify cutoff scores for different age levels. Subjects were recruited from several nursing homes and communities in Changchun, China. They were divided into a healthy control group (n=64) and an MCI group (n=62). All subjects were administered the VSP and a series of neuropsychological examinations. The study determined the optimal cutoff, discriminating validity, concurrent validity, and retest reliability of the VSP. We used the area under the receiver operating characteristic curve (AUC) to evaluate the discriminating validity and obtain the optimal cutoff values. Pearson correlation analysis and the intraclass correlation coefficient were used to evaluate the concurrent validity and retest reliability, respectively. A cutoff score of 46.4 was optimal for the entire sample, yielding a sensitivity of 85.9% and specificity of 79.0% for differentiating individuals with MCI and healthy controls, and the AUC was 0.870 (95% CI 0.799-0.924). The median index of VSP score was 51.1 (range 42.6-60.0). There was a moderate positive correlation between the VSP total score and Mini-Mental State Examination score (r=0.429, P<.001). There was a strong positive correlation between VSP total score and Montreal Cognitive Assessment score (r=0.645, P<.001). The retest reliability of the VSP was feasible (r=0.588, P=.048). The VSP is interesting and feasible for subjects. It shows high sensitivity and specificity for the identification of MCI in older adults, which makes it a promising screening method. The VSP may be generalized to older adults in other countries, although some cultural adaptation may be necessary. Chinese Clinical Trial Registry ChiCTR2000040074; https://www.chictr.org.cn/showprojen.aspx?proj=64639
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