智能版MoCA评估系统在轻度认知功能障碍诊断中的应用价值研究

Diagnostic value of mild cognitive dysfunction by the intelligent version of the MoCA system

目的探讨智能版蒙特利尔认知量表(MoCA)评估系统在老年住院患者中识别轻度认知功能障碍(MCI)的价值。方法选取2020年7月至2022年12月期间在中南大学湘雅三医院神经内科和老年病科诊断为MCI的75例患者(MCI组)和195例认知功能正常的患者(正常对照组),分别给予智能版MoCA系统评估和简易智能状态检查量表(MMSE)评估,并分析评估结果。结果MCI组MoCA总评分及MMSE总分[(19.73±2.42)分和(24.81±2.33)分]均低于正常对照组[(24.47±2.02)分和(26.50±1.65)分],差异有统计学意义(P<0.01)。智能版MoCA最佳截断值为23.5分,其诊断MCI的灵敏度、特异度、Kappa值(96.0%、82.1%、0.690)均高于MMSE量表(90.0%、62.6%、0.428)。结论智能版对老年MCI具有较高的筛查价值,该系统诊断MCI的敏感性和特异性均高于MMSE。

Objective To investigate the efficacy of the intelligent version of the Montreal Cognitive Assessment Scale(MoCA)in identifying mild cognitive impairment(MCI)in elderly inpatients.Methods Seventy-five patients diagnosed with mild cognitive impairment(MCI group)from the Neurology and Geriatrics Departments of a tertiary hospital in Changsha City,along with 195 patients with normal cognitive function(normal control group),were selected between July 2020 and December 2022.Both groups underwent evaluations using the intelligent version of the Montreal Cognitive Assessment(MoCA)and the Mini Mental State Examination(MMSE),and the results were analyzed.Results The MCI group showed significantly lower total MoCA scores and MMSE scores[(19.73±2.42)us.(24.8±2.33)]compared to the normal control group[(24.47±2.02)us.(26.50±1.65)],with a statistically significant difference(P<0.01).The optimal cut-off score for the MoCA was found to be 23.5 points in diagnosing MCI,showing higher sensitivity,specificity,and kappa value(96.0%,82.1%,and 0.690)compared to the MMSE scale(90.0%,62.6%,and 0.428).Conclusions The intelligent MoCA has a high screening accuracy for identifying MCI in this population,demonstrating superior sensitivity and specificity compared to the MMSE.