Role of comprehensive geriatric assessment in screening for mild cognitive disorders

BACKGROUND The role of comprehensive geriatric assessment(CGA)in screening for mild cognitive disorders was not known.AIM To evaluate the role of CGA in screening for mild cognitive disorders.METHODS A total of 100 elderly people who underwent health examinations in our hospital and community between January 2020 and December 2021 were included for analysis.Using Petersen as the diagnostic gold standard,healthy individuals were included in the control group and patients with mild cognitive impairment were assigned to the study group.The correlation between the cognitive function of the patients and their baseline clinical profiles was analyzed.Patients'Montreal Cognitive Assessment(MoCA)and CGA screening results were compared,and the sensitivity and specificity were calculated to assess the screening role of CGA.RESULTS CGA assessment yielded higher diagnostic accuracy than MoCA.The results of the multivariate regression analysis showed no correlation of gender,age,body mass index and literacy with cognitive function.Patients with mild cognitive impairment obtained significantly lower MoCA scores than healthy individuals(P<0.05).In the CGA scale,patients with mild cognitive impairment showed significantly lower Mini-mental State Examination,Miniature Nutritional Assessment and Berg Balance Scale scores,and higher Activity of Daily Living,Instrumental Activities of Daily Living Scale and Frailty Screening Inventory scores than healthy individuals(P<0.05),whereas the other assessment scales showed no significant differences(P>0.05).The CGA provides higher diagnostic sensitivity and specificity than the MoCA(P<0.05).CONCLUSION CGA allows accurate identification of mild cognitive impairment with high sensitivity and specificity,facilitating timely and effective intervention,and is thus recommended for clinical use.

Agreement and conversion formula between mini-mental state examination and montreal cognitive assessment in an outpatient sample

AIM To explore the agreement between the mini-mental state examination(MMSE) and montreal cognitive assessment(Mo CA) within community dwelling older patients attending an old age psychiatry service and to derive and test a conversion formula between the two scales.METHODS Prospective study of consecutive patients attending outpatient services.Both tests were administered by the same researcher on the same day in random order.RESULTS The total sample(n = 135) was randomly divided into two groups.One to derive a conversion rule(n = 70),and a second(n = 65) in which this rule was tested.The agreement(Pearson's r) of MMSE and Mo CA was 0.86(P < 0.001),and Lin's concordance correlation coefficient(CCC) was 0.57(95%CI:0.45-0.66).In the second sample Mo CA scores were converted to MMSE scores according to a conversion rule from the first sample which achieved agreement with the original MMSE scoresof 0.89(Pearson's r,P < 0.001) and CCC of 0.88(95%CI:0.82-0.92).CONCLUSION Although the two scales overlap considerably,the agreement is modest.The conversion rule derived herein demonstrated promising accuracy and warrants further testing in other populations.

The relationship of montreal cognitive assessment scores to framingham coronary and stroke risk scores

We examined the relationship between a brief cognitive screening measure and Framingham Coronary and Stroke Risk scores. We administered the Montreal Cognitive Assessment (MoCA) to participants in the Dallas Heart Study, a community-based multiethnic study investigating the development of atherosclerosis. The composition of the group was 50% African American, 36% Caucasian and 14% Hispanic. There were 765 subjects (mean age 51 years) who had both Coronary and Stroke Risk scores and an additional 144 subjects with only Coronary Risk scores available. There was a small significant inverse relationship between MoCA and Framingham Coronary and Stroke Risk scores. MoCA scores were influenced by education, but were not influenced by age or by the presence of one or more apoE4 alleles.

AB033.The impact of visual impairment on the Montreal Cognitive Assessment

Background:Cognitive assessments,such as the Montreal Cognitive Assessment(MoCA),use components that assume intact sensory abilities,however,adults show concomitant decreases in visual acuity with increasing age.Scores on cognitive assessments are typically lower for individuals with visual impairments compared to individuals with normal/corrected to normal vision.But it is not clear if lowers scores on cognitive assessments are due to the assessments relying on visual stimuli,or if individuals with visual impairments are actually more likely to have cognitive impairments.Therefore we simulated visual impairments,i.e.,reduced visual acuity and contrast sensitivity,in young healthy adults to determine how this impacts their scores on a measure of cognitive ability,i.e.,the MoCA.Methods:Participants(n=19)completed one of the three version of the MoCA under three conditions(20/20,simulated 20/80,simulated 20/200).The MoCA was administered following the clinical protocols.Only participants that scored>26(i.e.,normal cognitive function)at 20/20 were included in the analysis.For comparison,we included MoCA data from a sample of older adults with normal vision(n=19,Mage=74,Acuity M=0.04 logMAR,SD=0.16)or visual impairment(n=19,Mage=79,Acuity M=0.35 logMAR,SD=0.3).Results:Acuity of participants at 20/20(M=0.06 LogMAR,SD=0.1),simulated 20/80(M=0.63,SD=0.18)and simulated 20/200(M=0.88,SD=0.19)showed that the participants experienced simulated acuity loss with the goggles.For the MoCA scores,we found a main effect of acuity(F=16.22,P<0.001,η2=0.375,BF10=5,618).Planned post hoc comparisons showed a significant difference between scores with a 20/20 acuity(M=27.26,SD=0.93)and 20/80(M=24.74,SD=1.66,t=5.62,ptukey<0.001,d=1.88),and between 20/20 and 20/200(M=25.63,SD=1.46,t=3.63,ptukey=0.002,Cohen’s d=1.33).However,no difference was observed between 20/80 and 20/200(t=−1.99,ptukey=0.125,d=0.572).The MoCA scores in older adults with normal vision(M=27.32,SD=2.41)and with visual impairment(M=26.68,SD=2.52),did not differ significantly(t36=−0.787,P=0.436,d=0.26,BF10=0.4).Conclusions:Our findings show that simulated reductions in visual acuity and contrast sensitivity lead to lower scores on measures of cognitive ability,specifically the MoCA.However,it appears that older adults with actual visual impairments may have developed compensatory strategies to adapt to this loss in visual acuity as there were no significant differences in scores of older adults with and without visual impairments.Therefore,we would recommend that when assessing an individual with visual impairments to conduct the cognitive test by re-scoring it without the visual components,e.g.,the MoCA Blind,to magnify the visual components,or to substitue the visual component when possible using auditory alternatives,e.g.,the oral trail making task.

Effects of a Cocktail Supplement of Ginkgo Biloba and Acai Extract on Cognitive Symptoms of Parkinson’s Disease

Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).

A Brief Clinical Assessment of Cognitive Deficit with Impaired Daily Living Functioning in Parkinson’s Patients with and without Dementia

Cognitive decline in Parkinson’s disease (PD) is defined as dementia which affects activities of daily living (ADL) function. Dementia is one of the recognized issues in the treatment of Parkinson’s disease patients (PDP) as it is becoming a major contributor to morbidity. The objective of our study was to evaluate the cognitive decline in Parkinson’s disease patients (PDP) and the influence of cognition on daily living function deterioration in cognitively impaired and cognitively unimpaired PDP. Cognitively impaired PDP (n = 24), and cognitively unimpaired PDP (n = 16) were administered MoCA and MMSE performance based tests for cognitive measurements and Alzheimer’s Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL) to determine everyday functioning. The significances of MoCA and MMSE among cognitively impaired PDP and cognitively unimpaired PDP in univariant analysis were P < 0.001 and P < 0.05. In partial correlation, MoCA was strongly related to ADL function as compare to MMSE (r = 0.623, P = 0.001). Cognitively impaired PDP showed significantly lower score on visuo-construction and attention. Among all variables of MoCA domains, attention is strongly associated with instrumental activity daily living (IADL) scores (logistic regression coefficient = 0.672, P = 0.01). These results suggest that dementia affects daily living performances especially the IADL tasks like attention and execution. Therefore, the assessment of complex daily activities particularly IADL is probably useful for the diagnosis of early stage cognitive impairment in PDP. Further MMSE test is less sensitive than MoCA for detecting significant cognitive decline in PDP and impaired attention is an important determinant of ADL functions in cognitively impaired PDP.

Relationship between β-amyloid protein 1-42, thyroid hormone levels and the risk of cognitive impairment after ischemic stroke

BACKGROUND Post-stroke cognitive impairment(PSCI)is not only a common consequence of stroke but also an important factor for adverse prognosis of patients.Biochemical indicators such as blood lipids and blood pressure are affected by many factors,and the ability of evaluating the progress of patients with PSCI is insufficient.Therefore,it is necessary to find sensitive markers for predicting the progress of patients and avoiding PSCI.Recent studies have shown thatβ-amyloid protein 1-42(Aβ1-42)and thyroid hormone levels are closely related to PSCI,which may be the influencing factors of PSCI,but there are few related studies.AIM To investigate the relationship between serum levels of Aβand thyroid hormones in acute stage and PSCI and its predicted value.METHODS A total of 195 patients with acute cerebral infarction confirmed from June 2016 to January 2018 were enrolled in this study.Baseline data and serological indicators were recorded to assess cognitive function of patients.All patients were followed up for 1 year.Their cognitive functions were evaluated within 1 wk,3 mo,6 mo and 1 yr after stroke.At the end of follow-up,the patients were divided into PSCI and non-PSCI according to Montreal cognitive assessment score,and the relationship between biochemical indexes and the progression of PSCI was explored.RESULTS Compared with patients with non-PSCI,the levels of Aβ1-42,triiodothyronine(T3)and free thyroxin were lower in the patients with PSCI.Repeated measures analysis of variance showed that the overall content of Aβ1-42 and T3 in PSCI was also lower than that of the non-PSCI patients.Further analysis revealed that Aβ1-42(r=0.348),T3(r=0.273)and free thyroxin(r=0.214)were positively correlated with disease progression(P<0.05),suggesting that these indicators have the potential to predict disease progression and outcome.Cox regression analysis showed that Aβ1-42 and T3 were important factors of PSCI.Then stratified analysis showed that the lower the Aβ1-42 and T3,the higher risk of PSCI in patients who were aged over 70,female and illiterate.CONCLUSION Aβ1-42 and T3 have the ability to predict the progression of PSCI,which is expected to be applied clinically to reduce the incidence of PSCI and improve the quality of life of patients.

Yizhi Xingnao prescription improves the cognitive function of patients after a transient ischemic attack

Patients with mild cognitive impairment after a transient ischemic attack were included in this study. They were treated with Yizhi Xingnao prescription, ergoloid mesylates or aspirin for 60 days. Evaluation using the Montreal Cognitive Assessment Scale showed that cognitive function was significantly improved in all patients, especially after the combined treatment of Yizhi Xingnao and aspirin. The scores from the Montreal Cognitive Assessment Scale were improved overall and the effective treatment rate was as high as 79%, which was higher than patients treated with a combination of ergoloid mesylates and aspirin, or aspirin alone. Our experimental findings indicate that YizhiXingnao prescription can improve mild cognitive impairment after a transient ischemic attack, and that it is more effective than ergoloid mesylates.

基于MoCA量表的55~65岁人群认知功能水平研究

目的调查55~65岁年龄组人群的认知功能水平以及主要临床表现。方法使用蒙特利尔认知评估量表(MoCA)对535例于2021年4月至9月在广州市第十一人民医院体检中心体检的55~65岁人群进行认知功能评估。结果在55~65岁年龄群体中,认知功能能力下降的比例为33.08%,其中55~60岁年龄组的比例为29.39%,61~65岁年龄组的比例为36.63%。认知功能水平随年龄增长而下降,男性61~65岁组相较于55~60岁组,记忆功能能力下降明显(P=0.030);女性61~65岁组相较于55~60岁组,语言功能能力下降明显(P=0.033)。结论55~65岁人群认知功能下降明显,男性中主要表现为记忆功能的衰退,女性主要表现在语言功能的下降。

Prognostic importance of cognitive impairment in heart failure patients

Background Cognitive impairment is common among chronic heart failure(HF)patients.The prognostic implications of cognitive impairment in HF patients have not been investigated before.We undertook a prospective registry study to evaluate the association between Montreal Cognitive Assessment(MoCA)score and 1-year outcomes of HF patients.

Association between plasma dipeptidyl peptidase-4 levels and cognitive function in perinatal pregnant women with gestational diabetes mellitus

BACKGROUND Dipeptidyl peptidase-4(DPP4)is associated with cognitive dysfunction in patients with type 2 diabetes.AIM To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant women with gestational diabetes mellitus(GDM).METHODS The study subjects were divided into three groups:GDM group(n=81),healthy pregnant(HP)group(n=85),and control group(n=51).The Montreal Cognitive Assessment(MoCA)was used to assess the cognitive status of each group.Venous blood samples were collected to measure blood lipids,glycated hemoglobin,and glucose levels.For each participant,a 3-mL blood sample was collected and centrifuged,and the serum was collected.Blood samples were stored at-80℃,and DPP4,interleukin-6(IL-6),and 8-iso-prostaglandin F2α(8-iso-PGF2α),and brain-derived neurotrophic factor(BDNF)were detected using ELISA.RESULTS The MoCA scores in the GDM and HP groups were significantly different from those in the control group in terms of visuospatial/executive function and attention(P<0.05);however,the scores were not significantly different between the GDM and HP groups(P>0.05).In terms of language,the GDM group had significantly different scores from those in the other two groups(P<0.05).In terms of memory,a significant difference was found between the HP and control groups(P<0.05),as well as between the GDM and HP groups.The levels of DPP4,IL-6,and 8-iso-PGF2αin the GDM group were significantly higher than those in the HP and control groups(P<0.05);however,the differences between these levels in the HP and control groups were not significant(P>0.05).The level of BDNF in the GDM group was significantly lower than that in the HP and control groups(P<0.05),although the difference in this level between the HP and control groups was not significant(P>0.05).CONCLUSION Cognitive dysfunction in perinatal pregnant women with GDM mainly manifested as memory loss,which might be associated with elevated DPP4 levels.

Influence of Occupational Noise Exposure on Cognitive Ability of Grinders

Purpose: To investigate whether long-term noise exposure affects the cognitive ability of grinders. Methods: Cumulative noise exposure (CNE) and LAeq.8h determination were used to characterize the level of individual noise exposure;the Montreal Cognitive Assessment (MoCA) test (Beijing version) was used to evaluate cognitive function. Results: We compared the basic situation of workers in different groups and individual noise exposure intensity of grinders was monitored. Multiple linear-regression analysis was made and score of MoCA in different group was finally drawn. Conclusion: CNE and total score of MoCA have the relationship of negative correlation (r = -0.303, p < 0.05) which means long-term occupational noise exposure can affect the cognitive ability of grinders.

Clinical Study of Endovascular Treatment of Severe Middle Cerebral Artery Stenosis or Occlusion and Vascular Cognitive Impairment

It is very important to study the factors affecting the incidence,progress and prognosis of patients with vascular dementia.50 cases of severe middle cerebral artery stenosis or occlusion underwent endovascular treatment(25 cases of mild cognitive dysfunction,25 cases of moderate cognitive dysfunction)were divided into two groups,where a medical drug treatment group and a control group established with 25 cases in each group.The cognitive function of each group of patients was evaluated before operation,7 days after operation,30 days after operation,and 180 days after operation.CTP was used to compare the hemodynamic changes in patients before and after operation.The severe stenosis or occlusion of the middle cerebral artery in patients can be improved,and the intracranial blood supply of patients with poorly compensated medial cranial circulation and hypoperfusion can be restored to a certain extent.Meanwhile,improvement of cognitive function was definitive in some patients with cognitive dysfunction.To guide the formulation of treatment plans for patients with severe middle cerebral artery stenosis or occlusion.

前庭性偏头痛患者认知功能测评及眼震视图分析

目的测评前庭性偏头痛(VM)患者认知功能水平,分析、探讨眼震视图(VNG)在VM患者认知功能中的评估价值。方法选择2022年3月—2023年6月在启东市人民医院诊疗的60例VM患者为研究对象(VM组),同期纳入无眩晕、偏头痛或其他神经系统疾病的60例正常者作为对照(NC组)。采用简易精神状态评价量表(MMSE)、蒙特利尔认知评估量表(MoCA)来评估VM组和NC组的总体认知水平,并使用重复性神经心理状态评定量表(RBANS)进行神经心理及多领域认知功能的全面测评,利用VNG观察VM患者眼动特征。结果与NC组相比,VM组患者轻度认知障碍(MCI)的发生率明显增加,MoCA评分显著降低,差异具有统计学意义(P<0.01);在即刻记忆、视觉广度、语言功能、注意力、延时记忆、处理速度和执行功能多个认知域均存在明显受损,差异具有统计学意义(P<0.05);与NC组相比,VM组患者MMSE评分偏低,但差异无统计学意义(P>0.05)。从VNG结果分析,VM组患者扫视试验、平稳跟踪试验、视动试验、位置性眼震的发生率均高于NC组,差异具有统计学意义(P<0.05);而自发性眼震、凝视试验的发生率与NC组相比差异无统计学意义(P>0.05)。结论VM患者认知功能损害较明显,体现在记忆力、语言能力、视觉广度、注意力、处理速度及执行功能等方面;分析VNG特征,发现前庭系统对VM患者的认知功能有显著影响。

脑微出血与脑小血管病患者认知功能障碍的相关性研究

目的探讨脑微出血(cerebral microbleeds,CMBs)与脑小血管病患者认知功能障碍的相关性。方法选取2020年1月至2022年12月南京中医药大学连云港附属医院脑病科收治的脑小血管病患者80例为研究对象,依据大脑半球有无CMBs分为CMBs阳性组(50例)和CMBs阴性组(30例)。比较两组患者的一般临床资料,采用蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)评估患者的认知功能。结果CMBs阳性组患者的年龄、高血压发生率均显著高于CMBs阴性组(P<0.05)。CMBs阳性组患者的MoCA总分及视空间与执行功能、抽象思维、延迟回忆评分均显著低于CMBs阴性组(P<0.05)。结论CMBs与脑小血管病患者认知损害的潜在机制、临床诊断及程度评估密切相关。

Differences in cognitive profiles between traumatic brain injury and stroke： A comparison of the Montreal Cognitive Assessment and Mini-Mental State Examination

Purpose： To investigate the profiles of cognitive impairment through Montreal Cognitive Assessment （MoCA） and Mini-Mental State Examination （MMSE） in patients with chronic traumatic brain injury （TBI） or stroke and to evaluate the sensitivity of the two scales in patients with TBI. Methods： In this cohort study, a total of 230 patients were evaluated, including TBI group （n = 103） and stroke group （n - 127）. The cognitive functions of two groups were evaluated by designated specialists using MoCA （Beijing version） and MMSE （Chinese version）. Results： Compared with the patients with stroke, the patients with TBI received significantly lower score in orientation subtest and recall subtest in both tests. MoCA abnormal rates in the TBI group and stroke group were 94.17% and 86.61% respectively, while MMSE abnormal rates were 69.90% and 57.48%, respectively. In the TBI group, 87.10% patients with normal MMSE score had abnormal MoCA score and in the stroke group, about 70.37% patients with normal MMSE score had abnormal MoCA score. The diagnostic consistency of two scales in the TBI group and the stroke group were 72% and 69%, re.spectively. Conclusion： In our rehabilitation center, patients with TBI may have mare extensive and severe cognitive impairments than patients with stroke, prominently in orientation and recall domain. In screening post- TBI cognitive impairment, MoCA tends to be more sensitive than MIV[SE.

以蒙特利尔认知评估量表(MoCA)分析血管源性轻度认知障碍的神经心理学特征

目的利用蒙特利尔认知评估量表(MoCA)探讨血管源性轻度认知障碍(vMCI)的神经心理学特征,为早期发现、早期诊断、早期干预vMCI提供借鉴之处,并对敏感亚项认知域进行分析,以期探讨此类疾病的发生、发展规律。方法将107例vMCI患者的神经心理学检查结果进行各认知领域的亚项分析。结果 vMCI各认知域障碍发生率的不一致、MoCA中的各认知域与总分的相关性分析表明,注意、视空间与执行能力与量表总分密切相关,同时也表明,此次调研患者认知域损害以注意、视空间与执行能力损害为主。结论 MoCA中的相关子域能够很好地筛查出vMCI;MoCA中的延迟记忆及执行能力与总分相关性较强,说明vMCI患者的执行能力与延迟记忆能力密切相关。

急性脑卒中发病后认知功能改变的患者MRS与MoCA得分相关性分析

目的探讨急性脑卒中发病后认知功能改变的患者磁共振波谱检查(MRS)与蒙特利尔认知评估量表(MoCA)得分的相关性。方法选取2015年3月至2017年8月大庆龙南医院收治的急性脑卒中患者97例,使用简易精神状态检查量表(MMSE)对患者认知功能障碍进行判断,将急性脑卒中合并认知功能障碍的患者纳入认知功能障碍组(54例),无明显认知功能障碍的患者纳入单纯脑卒中组(43例)。此外,选取同期体检的健康志愿者纳入健康对照组(30名)。对三组受试者分别进行MoCA评分,检测血清白细胞介素(IL)-1β、IL-6以及肿瘤坏死因子-α(TNF-α)水平,并进行MRS检查。结果认知功能障碍组患者MoCA评分显著低于单纯脑卒中组和健康对照组[(18.59±4.18)分比(27.58±1.22)分、(28.33±1.29)分](P<0.01),而单纯脑卒中组和健康对照组MoCA评分比较差异无统计学意义(P>0.05)。三组受试者MRS各项指标进行比较差异有统计学意义(P<0.01),其中认知功能障碍组左侧和右侧N/乙酰天门冬氨酸盐(NAA)/肌酸(Cr)显著低于单纯脑卒中组以及健康对照组(P<0.01),单纯脑卒中组左侧和右侧NAA/Cr显著低于健康对照组(P<0.01);认知功能障碍组左侧和右侧胆碱复合物(Cho)/Cr显著高于单纯脑卒中组以及健康对照组(P<0.01),单纯脑卒中组左侧和右侧Cho/Cr显著高于健康对照组(P<0.01)。三组受试者血清IL-1β、IL-6、TNF-α水平比较差异有统计学意义(P<0.01),其中认知功能障碍组患者显著高于单纯脑卒中组以及健康对照组(P<0.01),单纯脑卒中组显著高于健康对照组(P<0.01)。急性脑卒中认知功能障碍患者左侧和右侧NAA/Cr水平与MoCA呈正相关(r=0.632、0.555,均P<0.01),与血清IL-1β、IL-6以及TNF-α呈负相关(P<0.01);急性脑卒中认知功能障碍患者左侧和右侧Cho/Cr水平与MoCA呈负相关(r=-0.308、-0.396,均P<0.01),与血清IL-1β、IL-6以及TNF-α呈正相关(P<0.01)。结论MRS作为安全无创的影响学检查手段,能够对急性脑卒中发病后的认知功能进行客观评价,从而弥补神经功能量表的不足,有较高的应用价值。

MoCA量表在评估帕金森病患者认知功能中的应用

目的采用蒙特利尔认知评估量表(MoCA)分析帕金森病(PD)患者的认知功能损害的特点,并探讨MoCA在评估PD认知功能方面的应用价值。方法采用MoCA对35例PD患者进行认知功能评估,并进行各认知域的分析。结果 (1)本组研究对象的MoCA评分为20.51±5.767,其中7例患者MoCA≤26分,占20.0%;(2)PD患者各认知域障碍的发生率不一致,依次为语言(34例,97.1%)、延迟记忆(32例,91.4%)、视空间与执行能力(30例,85.7%)、抽象思维(27例,77.1%)、注意(23例,68.6%)、命名(13例,37.1%)和定向力(12例,34.3%);(3)MoCA的各认知域与总分的相关系数都大于0.50,P<0.01。结论 (1)MoCA是评估PD患者认知功能的高效快捷的工具;(2)PD患者常见的认知功能损害包括语言、延迟记忆、视空间与执行能力、抽象思维和注意,而命名和定向力相对损害较轻。

MMSE和MoCA在不同类型轻度认知障碍筛查中的应用

目的探讨简易精神状态量表（ MMSE）和蒙特利尔认知评估量表（ MoCA）在遗忘型轻度认知障碍（aMCI）和轻度血管性认知障碍（mVCI）患者中的应用。方法从2012年3月至2015年3月本科收治的年龄60～80岁近200例患者中筛选出aMCI组42例， mVCI组50例，采用分组对照研究，所有患者经过临床痴呆评定量表（ CDR）和日常生活能力量表（ ADL）评估与接受MoCA 量表中文版和MMSE 量表进行认知功能评估。 MoCA与MMSE的评估间隔1h以上，在同一天进行。结果两组患者性别构成比、年龄及受教育程度间差异均无统计学意义（ P＞0．05）。 MMSE量表测评两组间差异无统计学意义（ P＞0．05）。两组间MMSE分项比较，除 aMCI组延迟回忆得分低于mVCI组（P＜0．05）外，其余各分项得分无显著性差异（P＞0．05）。 mVCI组患者MoCA总分较aMCI组水平低，差异有统计学意义（ P＜0．05）。两组间MoCA分项比较，mVCI组视空间执行功能、注意力与计算各项得分低于aMCI 组，差异有统计学意义（ P＜0．05）。 aMCI 组延迟回忆得分低于mVCI组，差异有统计学意义（ P＜0．05）。余各分项得分两组间无显著性差异（ P＞0．05）。 mVCI组患者在交替连线、立方体画图及指针得分均低于aMCI组，差异有统计学意义（ P＜0．05）。相关性分析显示MMSE与MoCA评分呈正相关关系，aMCI患者中相关系数为0．861，mVCI患者中相关系数为0．762，差异均有统计学意义（ P＜0．05）。结论 mVCI患者存在包括视空间执行功能、注意力及计算力等多个领域认知功能的损害，与aMCI患者相比，执行功能受损更明显。 MoCA是筛查aMCI及mVCI 的一个简便、有效的工具，敏感性高于MMSE，尤其适于对mVCI患者的早期筛查。