Six-item screener to identify cognitive impairment among potential subjects for clinical research
Six-item screener to identify cognitive impairment among potential subjects for clinical research
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DOI：
10.1097/00005650-200209000-00007
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发表时间：
2002-09-01
期刊：
影响因子：
3
通讯作者：
Hendrie, HC
中科院分区：
文献类型：
--
作者：
Callahan, CM;Unverzagt, FW;Hendrie, HC
OBJECTIVE.设计一个简单的认知筛选器，具有可接受的敏感性和特异性，用于识别认知障碍受试者。队列一是从一个以社区为基础的调查，加上第二阶段的诊断评估，使用正式的诊断标准为痴呆症。队列2是由转介到痴呆症专科诊所的患者组成的，他们完成了相同的诊断评估。印第安纳州印第安纳波利斯的城市社区和印第安纳州阿尔茨海默病中心。队列一由344名社区居住的黑人组成，他们是从印第安纳波利斯随机抽取的2212名65岁及以上的黑人中确定的;队列二由651名被转介到阿尔茨海默病中心的受试者组成。痴呆症的正式诊断临床评估，包括简易精神状态检查（MMSE）评分，来自MMSE的六项筛选，祝福痴呆评定量表（BDRS）和单词列表回忆。根据临床评价，受试者被分类为无认知障碍、认知障碍-非痴呆或痴呆。以社区为基础的样本的平均年龄为74.4岁，59.4%的样本为妇女，平均受教育年限为10.1年。该样本中痴呆的患病率为4.3%，认知障碍的患病率为24.6%。使用三个或更多错误的截止值，六项筛选器诊断痴呆的灵敏度和特异性分别为88.7和88.0。在相同的样本中，使用23分作为临界值的MMSE的相应敏感性和特异性分别为95.2和86.7。两个量表的性能在两个研究人群中具有可比性，并使用认知障碍或痴呆作为金标准。六项筛选中错误的增加与认知障碍较长测量的较差分数高度相关。六项筛选器是一种用于识别认知障碍受试者的简单可靠的工具，其诊断特性与完整的MMSE相当。它可以通过电话或面对面的面试来管理，并且很容易通过简单的错误总结来评分。
OBJECTIVE. To design a brief cognitive screener with acceptable sensitivity and specificity for identifying subjects with cognitive impairmentDESIGN. Cohort one is assembled from a community-based survey coupled with a second-stage diagnostic evaluation using formal diagnostic criteria for dementia. Cohort two is assembled from referrals to a specialty clinic for dementing disorders that completed the same diagnostic evaluation.SETTING. Urban neighborhoods in Indianapolis, Indiana and the Indiana Alzheimer Disease Center.PATIENTS. Cohort one consists of 344 community-dwelling black persons identified from a random sample of 2212 black persons aged 65 and older residing in Indianapolis; cohort two consists of 651 subject referrals to the Alzheimer Disease Center.MEASUREMENTS. Formal diagnostic clinical assessments for dementia including scores on the Mini-mental state examination (MMSE), a six-item screener derived from the MMSE, the Blessed Dementia Rating Scale (BDRS), and the Word List Recall. Based on clinical evaluations, subjects were categorized as no cognitive impairment, cognitive impairment-not demented, or demented.RESULTS. The mean age of the community-based sample was 74.4 years, 59.4% of the sample were women, and the mean years of education was 10.1. The prevalence of dementia in this sample was 4.3% and the prevalence of cognitive impairment was 24.6%. Using a cut-off of three or more errors, the sensitivity and specificity of the six-item screener for a diagnosis of dementia was 88.7 and 88.0, respectively. In the same sample, the corresponding sensitivity and specificity for the MMSE using a cut-off score of 23 was 95.2 and 86.7. The performance of the two scales was comparable across the two populations studied and using either cognitive impairment or dementia as the gold standard. An increasing number of errors on the six-item screener is highly correlated with poorer scores on longer measures of cognitive impairment.CONCLUSIONS. The six-item screener is a brief and reliable instrument for identifying subjects with cognitive impairment and its diagnostic properties are comparable to the full MMSE. It can be administered by telephone or face-to-face interview and is easily scored by a simple summation of errors.