MMSE与CDR检测社区老年人认知障碍的有效性比较

Comparison of the value of MMSE and CDR in detecting cognitive impairment among community-dwelling elderly

目的比较两种常用的筛查量表——简易智能精神状态检查量表(MMSE)和临床痴呆评定量表(CDR)在社区老年人中检测与阿尔茨海默病(AD)相关认知损害的敏感性和特异性。方法选取桂林市象山社区400名60岁及以上老年人作为研究对象,分别来用CDR和MMSE对研究对象及知情者进行测评,进行为期2年的随访,比较两种量表的初始筛查疑似率和判断疾病严重程度的差异。结果MMSE初始筛查疑似率(10.75%)高于CDR(5.50%),差异具有统计学意义(P<0.05)。MMSE在记忆、计算和回忆能力评估中表现出优越性,而CDR则在社会活动与兴趣爱好等日常生活能力方面评估中具有优势,可考虑作为MMSE的补充,利于提高敏感性。轻度认知功能障碍(MCI)的诊断率方面,MMSE阳性率(8.75%)高于CDR(4.75%)(P<0.05)。结论MMSE早期识别MCI的敏感度略高于CDR,两者联合取舍优缺点再进一步评估可减少漏诊,在早期筛查、预防和延缓AD方面具有重要的临床意义。

Objective To compare the sensitivity and specificity of the mini-mental state examination(MMSE)and the Clinical Dementia Rating(CDR)in detecting cognitive impairment related to Alzheimer′s disease(AD)among community-dwelling elderly.Methods 400 elderly individuals aged 60 and above from the Xiangshan community in Guilin,were selected as subjects.The CDR and MMSE scales were used to assess the subjects and informants,followed by a two-year follow-up to compare the initial screening rates and the severity of the disease as determined by the two scales.Results The initial screening rate of MMSE(10.75%)was higher than CDR(5.50%),showing a statistically significant difference(P<0.05).MMSE demonstrated superiority in memory,calculation,and recall abilities,while CDR showed assessment advantages in daily life abilities such as social activities and hobbies,which can be considered supplementary content to improve MMSE′s sensitivity.MMSE positivity rate(8.75%)was higher than CDR(4.75%)in diagnosis rate of mild cognitive impairment(MCI)(P<0.05).Conclusion MMSE is slightly more sensitive than CDR in early identification of MCI.Combining MMSE and CDR reduces misdiagnosis,which is of great clinical significance for early screening,prevention,and delay of AD in the community.