蒙特利尔认知评估量表中文版广州市老人院人群划界分的探讨.docVIP

蒙特利尔认知评估量表中文版广州市老人院人群划界分的探讨 　　【摘 要】 目的：初步探讨蒙特利尔认知评估量表（MOCA）筛查广州老人院人群中的轻度认知损害患者的最佳截断点。方法：选取广州多所老人院能配合并完成量表测试的老年人，按临床标准诊断分组纳入对象230名，进行MOCA得分截断值的初步探讨。结果：经过绘制受试者工作曲线（ROC），根据敏感性和特异性对应的最大约登指数，MOCA得分值在25或以上为正常，其敏感性和特异性分别为1.00和0.96，14分以上为轻度认知损害(MCI), 其敏感性和特异性分别为0.872和0.836,与临床诊断观察符合率为0.891；机遇符合预期值为0.545，Kappa 值为0.760,与临床金标准诊断结果符合很好。结论：MOCA量表能很好地筛查出广州老人院的MCI患者，为我国老年人群的认知筛查提供参考的依据。适合广州老人院的MCI和正常人群最佳截断点为25；MCI和痴呆(AD)患者的最佳截断点为15，初步确定广州老人院中MCI的MOCA分值范围为15－24。 　　【关键词】 轻度认知损害；认知评估；蒙特利尔认知评估表；截断点；老年人群；心理测量学研究 　　中图分类号：B842.1 文献标识码：A 文章编号：1000-6729(2008)002-0123-04 　　Determination of the Cut-off Point of the Chinese Version of the Montreal 　　Cognitive Assessment among Chinese Elderly in Guangzhou 　　ZHANG Li-Xiu，LIU Xue-Qin 　　Zhujiang Hospital of Southern Medical University，Guangzhou 510280 　　【Abstract】Objective:To determine optimal cut-off-point of the Chinese version of the Montreal Cognitive Assessment (MOCA) in patients with mild cognitive impairment in Guangzhou.Methods: 230 people of gerocomium meeting studying criterion were included, the MOCA were administered to all subjects, to evaluate the cut-off-point of MOCA. Results:Score of optimal cut-off -point of the MOCA was 25 in ROC curve analyses as well as the largest Youdens index. Sensitivity and specificity were found to be 1.000 and 0.962 respectively, when the cut off point was 25 to distinguish MCI from normal controls. Sensitivity and specificity were found to be 0.872 and 0.836 when the cut off point was 14 to distinguish MCI and AD. The agreement rate of observation was 0.891, the agreement rate by chance was 0.545, and Kappa value was 0.94, which were agree with theresult of clinical diagnosis.Conclusion:The MOCA is good at screening patients with MCI in the gerocomium of Guangzhou, which could provide reference to assessment the cognitive impairment of other elderly. The score of optimal cut-off point of MOCA is 25 when distinguish MCI and normal. 　　【Key words】 the mild cognitive impairment; cognitive assess