社区老年人轻度认知障碍筛查量表应用策略研究

Strategy for the Choice of Appropriate Mild Cognitive Impairment Screening Scales for Community-dwelling Older Adults

随着我国老龄化进程的加深、加快,老年人轻度认知障碍(MCI)的发病率逐年升高,而早期诊断筛查MCI对于降低痴呆的发病率具有重要的社会意义。本文收集和综合分析了国内外临床实践中常用的MCI筛查评估量表(老年人认知功能减退知情者调查问卷,剑桥神经心理测试自动化成套量表,蒙特利尔认知评估量表,画钟试验、钟表读数试验、钟表设置试验,美国阿尔茨海默病联合登记协作组织的评估条目,8条目痴呆筛查问卷,Addenbrooke认知评估量表,全科医生认知功能评估量表),结合各量表的优缺点,提出将用时短且高效的8条目痴呆筛查问卷、老年人认知功能减退知情者调查问卷与灵敏且全面的Addenbrooke认知评估量表联合使用的量表组合策略,该策略可以很好地弥补各量表的不足,适用于我国社区老年人MCI的早期筛查、识别。

With the deepening and acceleration of the aging process,an increasing prevalence of mild cognitive impairment(MCI)is found in China's elderly population.To reduce MCI prevalence in this group,early screening and diagnosis are approaches having great social significance.To provide support for the choice of appropriate tools for early screening and identifying MCI in community-dwelling Chinese older adults,we comprehensively reviewed the commonly used scales in clinical MCI screening and assessment〔Informant Questionnaire on Cognitive Decline in the Elderly Individuals(IQCODE),Cambridge Neuropsychological Test Automated Battery,Montreal Cognitive Assessment,Clock Drawing Test,Clock Reading Test,Clock Setting Test,Consortium to Establish a Registry for Alzheimer's Disease,Ascertain Dementia 8(AD8),Addenbrooke's Cognitive Examination-Revised(ACE),and General Practitioner Assessment of Cognition〕,and put forward a strategy after analyzing the advantages and disadvantages of each of the above-mentioned scales,namely,combined use of the quick and highly effective AD8,IQCODE,and the sensitive and comprehensive ACE,for these three scales may make up for each other's shortcomings when they are used together.