[Establishment of a short-form screening test for cognitive decline as part of a newly developed comprehensive geriatric assessment initiative named 'Dr. Superman'].
[Establishment of a short-form screening test for cognitive decline as part of a newly developed comprehensive geriatric assessment initiative named 'Dr. Superman'].
复制标题
[建立认知能力下降的简短筛查测试，作为新开发的综合老年评估计划的一部分，名为“Dr.”
DOI：
10.3143/geriatrics.49.241
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
T. Iwamoto
中科院分区：
文献类型：
--
作者：
Takeshi Ohnuma;H. Kanetaka;T. Iwamoto
目标
认知功能的评估在老年综合评估(CGA)中是重要的，目前已有几种标准化的痴呆筛查测试，如简易智力状态检查(MMSE)。然而，执行MMSE需要5到20分钟。我们开发了一项名为“超人博士”的CGA计划，旨在10分钟内完成CGA。在这项研究中，我们评估了在MMSE之前对认知衰退的一种简短的筛查测试。
方法
MMSE和一个关于情节记忆的问题(“你昨晚吃了什么？”)对90名患有各种疾病的老年门诊患者进行了测试。根据MMSE评分分为正常组(MMSE评分≥24)和异常组(MMSE评分≤23)。在这些组中，分别对每个领域(D)(D1：时间定向，D2：地点定向，D3：即时记忆，D4：计算，D5：回忆，D6：语言，D7：空间认知)和情节记忆分别进行评分，并计算其敏感度、特异度和阳性预测值。在这些数据的基础上，对领域的最佳组合进行了评估，以便作为评估工具实际使用。
结果
MMSE评分10~30分，其中42例为正常组。D_1、D_2、D_4、D_5和情景记忆类别具有较高的敏感性、特异性或阳性预测值。根据这些领域中每个项目的特点进行简式评估，在D1中选择“今年是什么”，在D4中选择“连载7‘S两次”和关于情节记忆的问题组合优于其他组合(敏感度：93.8%；特异度：71.4%；阳性预测值：78.9%)。使用这种组合对50名门诊患者和2名评分员进行评估，需要32到55秒才能完成评估，评价员之间的可靠性很好(κ=0.861)。
结论
《今年是怎么回事》、《连续剧7》《S两次》、《昨晚吃了什么菜》的组合。是最好也是最有价值的认知能力下降的简短筛查测试。
AIM
The assessment of cognitive function is important in comprehensive geriatric assessment (CGA), and several standardized screening tests for dementia such as the Mini-Mental State Examination (MMSE) are available. However, it takes 5 to 20 minutes to perform the MMSE. We have developed a CGA initiative named 'Dr. Superman' which is designed to accomplish CGA within 10 minutes. In this study, we evaluated a short-form screening test for cognitive decline preceding the MMSE.
METHODS
The MMSE and a question on episodic memory, ("What kind of food did you have last night?") were administered to 90 elderly outpatients with various diseases. They were divided into 2 groups according to their MMSE scores: a normal group (MMSE score≥24) and an abnormal group (MMSE score≤23). Within these groups, each domain (D) (D1: time orientation, D2: place orientation, D3: immediate memory, D4: calculation, D5: recall, D6: language, and D7: spatial cognition) and episodic memory was separately scored and the sensitivity, specificity, and positive predicative value of each were calculated. Based on these data, the best combination of the domains was evaluated for practical use as an assessment tool.
RESULTS
The MMSE scores ranged from 10 to 30, and 42 cases were classified into the normal group. High sensitivity, specificity, or positive predicative value was observed in D1, D2, D4, D5 and episodic memory categories. On the basis of the characteristics of each item in these domains in order to make a short-form assessment, a combination of "What is this year" in D1, "Serial 7's twice" in D4, and a question on episodic memory was found to be superior to other combinations (sensitivity: 93.8%; specificity: 71.4%; positive predicative value: 78.9%). Using this combination for 50 outpatients with 2 raters, it took 32 to 55 seconds to accomplish the assessment with good inter-rater reliability (κ=0.861).
CONCLUSIONS
The combination of "What is this year?", "Serial 7's twice", and "What kind of food did you have last night?" was the best and most valuable short-form screening test for cognitive decline.