蒙特利尔认知评估量表在乌鲁木齐维吾尔族人群中应用的初步研究

A preliminary study of application of Montreal Cognitive Assessment among the Uyghur people inUrumqi

目的对维吾尔文版蒙特利尔认知评估量表（MoCA-U）在乌鲁木齐地区维吾尔族人群中应用的信度及效度进行检验，并初步确定该量表筛查维吾尔族认知障碍人群的最佳界值。方法对英文版MoCA量表进行翻译并修订成维吾尔文版，选择188名50-75岁的维吾尔族研究对象，其中正常对照组80名、轻度认知功能障碍（MCI）组68例、痴呆组40例，分别用MoCA-U、简易精神状态量表（MMSE）、临床痴呆量表（CDR）等神经心理学量表进行评估比较。结果（1）MoCA-U的克朗巴赫α系数为0．801，评定者间一致性组内相关系数为=0．977（95％可信区间：0．949-0．990），重测信度r=0．987（P〈0．001）。（2）正常对照组、MCI组、痴呆组的MoCA-U总分分别为（22．65±2．57）、（18．56±3．08）、（9．43±3．89）分，3组比较差异有统计学意义（F=27．991，P〈0．001）；MoCA-U与MMSE、CDR量表总分的相关系数分别为r=0．84（P〈0．001）和r=-0．77（P〈0．001）。（3）当研究对象受教育年限≤5年时，MoCA-U筛查MCI的最佳界值为20分，此时MoCA-U灵敏度为86．4％，特异度为84．2％；筛查痴呆的最佳界值为13分，此时的灵敏度为94．1％、特异度为100％。受教育年限6-10年时，MoCA-U筛查MCI的最佳界值为21分，灵敏度为84．6％，特异度为94．1％；筛查痴呆的最佳界值为15分．此时的灵敏度为100％，特异度为92．3％。受教育年限≥11年时，MoCA-U筛查MCI的最佳界值为22分，灵敏度为75．8％，特异度为70．5％；筛查痴呆的最佳界值为17分，此时的灵敏度为100％，特异度为84．8％。结论MoCA-U具有良好的信效度及可行性，适合对乌鲁木齐中老年维吾尔族人群认知功能进行评估；不同受教育程度人群筛查MCI的最佳界值为20-22分，筛查痴呆的最佳界值为13-17分。

Objective To evaluate the reliability and validity of Uyghur version of the Montreal Cognitive Assessment （MoCA-U）among the Uyghur people in Urumqi, and determine the optimal cutoff score of MoCA-U to detect the cognitive impairment in the Uyghur people. Methods The English MoCA was translated and adapted into the Uyghur version. The MoCA-U, MMSE, CDR and other neuropsychological batteries were administered to 188 Uyghur people who were aged 50 -75, 80 of them were in the normal cognitive group, 68 of them were in the mild cognitive impairment （MCI） group and 40 of them were in the dementia group. Results （ 1 ） Cronbach＇s α of MoCA-U was 0. 801, inter-rater reliability ICC was 0. 977 （95% CI：0. 949 - 0. 990）, test-retest reliability r was 0. 987 （ P 〈 0. 001 ）. （ 2 ） The MoCA-U scores of 3 groups were normal cognitive （ 22.65 ±2. 57 ）, MCI （ 18.56 ± 3.08 ） and dementia （ 9.43± 3.89 ）, were significantly different among the 3 groups（ F = 27. 991 ,P 〈 0. 001 ）. The correlation coefficients of the scores of MoCA-Uwith those of MMSE and CDR were r =0.84（P 〈0.001）and r = -0.77（P 〈0.001）. （3） MoCA-U scores in the participants with 5 years of education or less, using a cutoff score of 20, the MoCA-U had a sensitivity of 86.4% and a specificity of 84.2% for screening MCI, and using a cutoff score of 13, the MoCA-U had a sensitivity of 94. 1% and a specificity of 100% to detect dementia. In theparticipants within 6- 10 years of education, using a cutoff score of 21, the MoCA-U had a sensitivity of 84. 6% and a specificity of 94. 1% for screening MCI, and using a cutoff score of 15, the MoCA-U had a sensitivity of 100% and a specificity of 92. 3% to detect dementia. In the participants with more than 11 years of education, using a cutoff score of 22, the MoCA-U had a sensitivity of 75.8% and a specificity of 70. 5% for screening MCI, using a cutoff score of 17, the MoCA-U had a sensitivity of 100% and a specificity of 84. 8% to detect dementia. Conclusion The MoCA-U has a good reliability, validity and feasibility, and is suitable for use as a screening tool to screen cognitive function in elderly Uyghur people in Urumqi. The optimal cutoff score for different education years to screen MCI is 20 - 22, screen dementia is 13 - 17.