词语记忆量表对轻度认知功能障碍及阿尔茨海默病患者的临床意义

Study on the clinical significance of word memory scale in patients with mild cognitive impairment and Alzheimer's disease

目的探讨词语记忆量表在老年患者轻度认知功能障碍(Mild cognitive impairment,MCI)和轻度阿尔茨海默病(Alzheimer's disease,AD)诊断中的应用价值。方法共纳入270例受试者,采集其基本资料。在全面诊断流程的基础上进行专业性诊断。其中108例认知功能正常,105例MCI患者,57例轻度AD患者。对受试者行简易智能精神状态检查量表(MMSE)以及词语记忆量表测试。词语记忆量表由本课题组自主研发,用于评估词语的延时回忆(Wd)和原词延时再认(Wr)。运用受试者工作特征(ROC)曲线下面积(AUC)对MMSE及词语记忆量表的诊断效能进行评价。结果与正常组比较,MCI组和轻度AD组的Wd及Wr评分明显降低,差异有统计学意义(P<0.001)。MCI组与轻度AD组的AUC值在MMSE、Wd、Wd+Wr之间差异无统计学意义(P>0.05)。通过ROC曲线最佳界值分析,我们确定了MCI组的MMSE、Wd和Wr的最佳界值分别为27分、3分和8分;轻度AD组的MMSE、Wd和Wr的最佳界值分别为26分、3分和7分。MCI组和轻度AD组的各项得分均显示出良好的一致性(P>0.05)。结论词语记忆量表的Wd、Wd+Wr的评分水平接近MMSE,表明应用词语记忆量表对MCI及轻度AD的诊断具有良好的应用价值。

Objective To explore the application value of word memory scale in the diagnosis of Mild cognitive impairment(MCI)and mild Alzheimer's disease(AD)in elderly patients.Methods A total of 270 participants were included in the study,and their basic data were collected.On the basis of a comprehensive diagnosis cases,professional diagnosis was performed.Among them,108 individuals had normal cognitive function,105 cases were diagnosed with MCI,and 57 cases were diagnosed with mild AD.All participants underwent the Mini-Mental State Examination(MMSE)and the Word Memory Scale test.The Word Memory Scale,developed independently by our research group,was used to assess delayed recall of words(Wd)and delayed recognition of words(Wr).The diagnostic efficacy of MMSE and the Word Memory Scale were evaluated using the area under the receiver operating characteristic(ROC)curve(AUC).Results Compared with the normal group,the Wd and Wr scores of the MCI group and the mild AD group were significantly lower(P<0.001).There was no significant difference in AUC of MMSE,Wd and Wd+Wr between the MCI group and the mild AD group.Through the analysis of the optimal threshold of the ROC curve,the optimal thresholds of MMSE,Wd and Wr in the MCI group were determined to be 27,3 and 8,respectively.The optimal thresholds of MMSE,Wd and Wr in the mild AD group were 26,3 and 7,respectively.The scores of Wd,Wd+Wr in the MCI group and the mild AD group showed good consistency(P>0.05).Conclusion The Wd and Wd+Wr of the Word Memory Scale are close to the MMSE score level.The application of the Word Memory Scale has a good screening application value for MCI and mild AD.