Combining cognitive testing and informant report to increase accuracy in screening for dementia
Combining cognitive testing and informant report to increase accuracy in screening for dementia
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DOI：
10.1176/ajp.155.11.1529
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发表时间：
1998-11-01
影响因子：
17.7
通讯作者：
Mulligan, R
中科院分区：
文献类型：
--
作者：
Mackinnon, A;Mulligan, R
目的：将认知测试和知情人报告问卷结合起来，以确定它们的组合使用是否可以提高痴呆症诊断筛查的准确性。开发并评估了可以容易地应用于临床环境的组合测试分数的方法。方法：受试者为106名在瑞士日内瓦大学医院系统记忆诊所接受老年病医院或门诊评估的患者。所用的工具是简易精神状态和简短形式的知情人问卷的认知功能下降的老年人。根据DSM-IV标准诊断痴呆。结果如下：Logistic回归分析表明，简易精神状态和老年人认知下降的知情人问卷相结合，导致更准确的预测病例比单独测试。通过使用受试者操作特征分析，研究了测试结果的逻辑“或”和“和”组合以及两项测试得分的加权和作为痴呆筛查的性能。通过使用合适的截止点，“或”规则和加权和都被证明能够提高性能，超过单独使用的任何一个测试。结论：这项研究表明，告密者的报告可以正式纳入评估痴呆症的方式，以增加检测的准确性的情况下，非病例。开发了一种图形方法，可以将最稳健的方法应用于个别情况，而无需任何计算。
Objective: Cognitive testing and an informant report questionnaire were combined to determine whether their use in combination could improve accuracy in screening for the diagnosis of dementia over either test used alone. Methods of combining test scores that can be readily applied in clinical settings were developed and assessed. Method: The subjects were 106 patients admitted to the geriatric hospital or outpatients assessed at the memory clinic of the university hospital system in Geneva, Switzerland. The instruments used were the Mini-Mental State and the short form of the Informant Questionnaire on Cognitive Decline in the Elderly. The diagnosis of dementia was made according to DSM-IV criteria. Results: Logistic regression demonstrated that the combination of the Mini-Mental State and the Informant Questionnaire on Cognitive Decline in the Elderly resulted in more accurate prediction of caseness than either test alone. The performance of logical "or" and "and" combinations of test results and a weighted sum of scores on the two tests as screens for dementia were investigated by using receiver operating characteristic analysis. By using suitable cutoff points, both the "or" rule and the weighted sum were shown to be capable of improving performance over that of either test used alone. Conclusions: This study shows that informant report can be formally incorporated into assessment for dementia in such a way as to increase the accuracy of detection of cases and noncases. A graphical method was developed that enables the most robust approach to be applied to individual cases without any calculation.