老年人快速认知筛查量表筛查早期阿尔茨海默病性痴呆的试测

Performance analysis of Quick Cognitive Screening Scale in screening early Alzheimer disease from community population

目的:考查老年人快速认知筛查量表(QCSS-E)筛查社区老年人轻度认知功能障碍(MCI)及轻中度阿尔茨海默病(AD)的性能。方法:在社区募集≥55岁老年人1298人,参照Peterson MCI诊断标准和DSM-5神经认知障碍AD诊断标准为金标准,将其分为正常对照(NC)组(n=629)、MCI组(n=573)及轻中度AD组(n=96)。计算量表总分及各维度得分筛查MCI和轻中度AD的阳性预测值、阴性预测值;采用ROC曲线分析检验量表总分的区分度。结果:量表总分筛查MCI的阳性预测值为67.6%,阴性预测值为83.9%;筛查轻中度AD的阳性预测值为64.2%,阴性预测值为96.9%。ROC曲线分析发现QCSS-E总分筛查正常与MCI、正常与轻中度AD、MCI与轻中度AD的AUC分别为83.5%、98.0%及85.6%。结论:QCSS-E总分及各维度得分在早期AD筛查中性能良好。

Objective:To investigate the efficiency of Quick Cognitive Screening Scale for Elderly(QCSS-E) in screening mild cognitive impairment(MCI) and mild-moderate dementia with Alzheimer Disease(AD) from the elderly in community.Methods:A total of 1298 elderly aged 55 years or more were recruited from a community and divided into normal control(NC) group(n=629),MCI group(n=573) and mild-moderate AD group(n=96) according to the Peterson MCI diagnostic criteria and DSM-5 neurocognitive impairment AD diagnostic criteria as the gold standard.According to the gold standard,the positive predictive value and negative predictive value of MCI and AD were calculated.ROC curve was used to analyze the differentiation of the total score of the scale.Results:The positive predictive value of MCI and the negative predictive value were 67.6% and 83.9% respectively.The positive predictive value of AD screening was 64.2% and the negative predictive value was 96.9%.ROC curve analysis found that the AUC of QCSS-E total score screening for normal and MCI,normal and mild-moderate AD,MCI and mild-moderate AD were 83.5%,98.0% and 85.6%,respectively.Conclusion:The QCSS-E total score and each dimension score perform well in early AD screening,among which visual space,verbal fluency,abstract ability and delayed memory are the sensitive indicators for early AD recognition.