CAJ | 학술논문

目的探讨简易智能精神状态量表(MMSE)和蒙特利尔认知评估量表(MoCA)差值在老年期痴呆鉴别诊断中的价值.方法收集就诊于我院门诊老年期痴呆患者331例,其中阿尔茨海默病(AD)组148例,血管性痴呆(VaD)组87例,混合性痴呆(MD)组44例,额颞叶痴呆(FTD)组41例,路易体痴呆(DLB)组11例,应用MMSE和MoCA分别评定痴呆患者的认知功能.结果 AD组MMSE与MoCA差值为(3.3±1.7)分,VaD组差值为(6.6±2.1)分,MD组差值为(6.6±2.1)分,FTD组差值为(5.4±2.3)分,DLB组差值为(6.1±1.9)分.5组间差异有统计学意义(F=46.420,P=0.000),AD组与非AD组比较差异有统计学意义(t=-13.429,P=0.000).轻、中度痴呆中,AD组和非AD组比较,MMSE和MoCA差值均有统计学意义(P=0.000).根据ROC曲线,确定MMSE与MoCA差值=5分为鉴别AD和非AD痴呆的切点,对应的敏感度和特异度分别为79.8％和78.4％,ROC曲线下面积为0.848,95％CI为0.807～0.890.结论 MMSE与MoCA差值可作为鉴别AD和非AD痴呆的辅助诊断方法之一.
목적 탐토간역지능정신상태량표(MMSE)화몽특리이인지평고량표(MoCA)차치재노년기치태감별진단중적개치.방법 수집취진우아원문진노년기치태환자331례,기중아이자해묵병(AD)조148례,혈관성치태(VaD)조87례,혼합성치태(MD)조44례,액섭협치태(FTD)조41례,로역체치태(DLB)조11례,응용MMSE화MoCA분별평정치태환자적인지공능.결과 AD조MMSE여MoCA차치위(3.3±1.7)분,VaD조차치위(6.6±2.1)분,MD조차치위(6.6±2.1)분,FTD조차치위(5.4±2.3)분,DLB조차치위(6.1±1.9)분.5조간차이유통계학의의(F=46.420,P=0.000),AD조여비AD조비교차이유통계학의의(t=-13.429,P=0.000).경、중도치태중,AD조화비AD조비교,MMSE화MoCA차치균유통계학의의(P=0.000).근거ROC곡선,학정MMSE여MoCA차치=5분위감별AD화비AD치태적절점,대응적민감도화특이도분별위79.8％화78.4％,ROC곡선하면적위0.848,95％CI위0.807～0.890.결론 MMSE여MoCA차치가작위감별AD화비AD치태적보조진단방법지일.
Objective To investigate the diagnostic significance of the difference values between Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)in elderly patients with dementia.Methods 331 elderly patients with dementia were collected from outpatients in our hospital.There were 148 people with Alzheimer's disease (AD),87 cases with vascular dementia (VaD),44 cases with mixed dementia (MD),41 cases with frontotemporal dementia (FTD) and 11 cases with dementia with Lewy bodies (DLB).MMSE and MoCA were applied to test the cognitive impairment separately.Results The difference values between MMSE and MoCA was (3.3±1.7) points,(6.6±2.1) points,(6.6±2.1) points,(5.4±2.3) points,(6.1 ± 1.9) points in AD,VaD,MD,FTD and DLB group respectively,and there were statistical differences among the five groups (F=46.420,P=0.000).Statistical differences were found in the difference values between MMSE and MoCA between dementia patients with AD and non-AD (t=-13.429,P=0.000).According to receiver operating characteristic curve (ROC curve),the optimal cut off point of the difference values between MMSE and MoCA for differential diagnosis between AD and non-AD dementia was 5 points,with 79.8％ sensitivity and 78.4％ specificity,and area under the curve was 0.848 (95％CI:0.807-0.890).Conclusions The difference values between MMSE and MoCA may be one of parameters for differential diagnosis between AD and non-AD dementia.