轻度认知障碍风险快速筛查工具的测算过程及判别效果分析

Measurement protocol and discriminant analysis of rapid screening tools for assessing the risk of mild cognitive impairment

目的结合神经心理学量表和认知范式,研发轻度认知障碍(MCI)风险快速筛查工具。方法应用北京老年脑健康促进计划(BABRI)队列研究两个基线数据集:数据集1受试者5 593例,MCI组患者1 500例,认知功能正常(对照组)4 093例;数据集2受试者588例,MCI组患者92例,认知功能正常(对照组)496例。数据集1用于对简易精神智能量表(MMSE)的分项目进行简化分析,选取对MCI判别能力最强的分项目组合成为认知快速测评(BABRI-mini MMSE);数据集2用于对编码-再认情景记忆范式进行MCI判别分析,将其改编成情景记忆量表(BABRI-EMT)。分析方法应用受试者工作特征曲线(ROC)。结果对照和MCI群体在各项认知能力和情景记忆任务表现上的差异有统计学意义(均P<0.01);应用数据集1对MMSE分项目进行测算,得到MMSE12和MMSE19两个分项目对MCI的判别能力最强,ROC下面积(AUC)分别为0.699、0.631;应用数据集2考察情景记忆成绩联合上述两个MMSE分项目对MCI的判别能力,AUC值0.732,敏感度0.731,特异度0.656。结论 BABRI-mini MMSE和BABRI-EMT适用于MCI风险大规模普适性筛查。

Objective To develop rapid screening tools for assessing the risk of mild cognitive impairment(MCI)based on neuropsychological scales and cognitive paradigms.Methods Two baseline datasets from the Beijing Ageing Brain Rejuvenation Initiative(BABRI)cohort were studied:dataset 1 contained 5593 subjects,with 1500 cases wilh MCI and 4093 cases with normal cognitive function(the control group);dataset 2 consisted of 588 subjects.with 92 cases with MCI and 496 cases with normal cognitive function(the control group).Dataset 1 was used to simplify the Mini-Mental State Examination(MMSE)%and the sub-item combination with the strongest MCI discriminative ability was selected to integrate into the cognitive rapid assessment(BABRI mini MMSE).Dataset 2 with scores of encoding-recognition episodic memory task was used for further MCI discriminant analysis and was adapted into an episodic memory test(BABRI-EMT).We applied the receiver operating characteristic curve(ROC)for those analyses.Results The control group and the MCI group showed significant differences in multi-domain cognitive ability and episodic memory task performance(P<0.01).Among sub-items of MMSE measured using dataset 1,MMSE12 and MMSE19 had the highest discriminative accuracy for MCL and the area under the ROC(AUC)was 0.699 and 0.631,respectively.Dataset 2 was used to investigate the discriminative ability of the episodic memory score in combination with the above two MMSE sub-items for MCI,and the AUC value was 0.732,the sensitivity was 0.731,and the specificity was 0.656.Conclusions The BABRI-mini MMSE and BABRI-EMT are suitable for the large-scale universal screening of MCI risk.