蒙特利尔认知评估量表的条目分析

Items in Montreal cognitive assessment

目的研究蒙特利尔认知评估量表（MoCA）各条目在正常体检人群中的分布特征，为北京版MoCA量表的应用及修改提供基础资料。方法选取我院干部门诊1350例体检人群为对象，其中自愿接受MoCA检查的857例，排除既往被诊断为不同类型认知障碍的80例，最后入组777例，均为男性，分为5组，其中〈65岁组175例，65～69岁组200例，70～74岁组145例，75～79岁组124例，≥80岁组133例。采用北京版MoCA量表对受检人员进行认知功能评测，对MoCA中的视空间与执行功能、命名、计算力与注意力、语言、抽象、延迟回忆、定向力各分项目的得分以“≤1／2项目分”和“≤项目平均分”为筛选务件进行比较。结果与〈65岁组、65～69岁组、70～74岁组比较，75～79岁组、≥80岁组MoCA平均得分明显降低（P〈0．05，P〈0.01）。777例患者中，MoCA平均得分为（26．83±2．58）分。分别以“≤1／2项目分”和“≤项目平均分”为筛选条件，低于筛选标准的患者占体检人群的百分比在MoCA的子条目比较，差异有统计学意义（P〈0.05）。2种筛选条件下，低于筛选标准患者占体检人群的百分比在10％以上的项目分别为“连线”、“复制立方体”、“复述1”、“1min动物数”、“抽象2”及“延迟回忆各项”，以“≤项目平均分”为筛选条件时，“画钟”和“100连续减7正确数”亦在10％以上。结论在正常体检人群中，MoCA各分项失分情况不尽相同，部分项目可能需要进一步修改以更好地应用于认知功能筛查。

Objective To provide the background information for the application and modification of Beijing version of Montreal cognitive assessment （MoCA） by studying the distribution charac- teristics of its items in normal subjects undergoing physical examination. Methods Of the 1350 subjects enrolled in this study,857 accepted physicl examination according to the MoCA. After 80 of them who were diagnosed as different types of cognitive impairment were excluded,777 male subjects were included in the present analysis. Their cognitive functions were assessed following the MoCA. The items in MoCA with a score ≤ 1/2 or≤ average item score were compared. Results The average MoCA score was 26.83 ± 2.58. The propotion of subjects with their item score ≤1/2 or≤average item score was significantly different （P〈0.05）, with trail making, copy- ing a cube, repeating sentence 1,1 minitute calculation of animals, abstraction 2,and delayed recall accounted for over 10%. Conclusion The loss of items in MoCA varies in normal subjects under- going physical examination. Certain itwms in MoCA should be modified.