目的: 调查湖南省湘潭市城乡社区老年人轻度认知障碍（MCI）患病率并探讨长沙版蒙特利尔认知评估量表（MoCA-CS）在社区老年人MCI筛查中的理想划界分值。方法: 采用多阶段分层整群抽样方法,对湘潭市城乡社区65岁以上老年人进行问卷调查,采用长沙版MoCA进行认知功能筛查,结合临床诊断并根据ROC曲线分析探索其筛查MCI的理想划界分值。结果: 湘潭市城乡社区822名老年人中MCI筛查阳性率为28.22%;根据ROC曲线分析,MoCA得分筛查MCI的曲线下面积为0.945,临界值为21.5,灵敏度和特异度分别为95.67%和82.06%;不同文化程度人群间MoCA得分的差异有统计学意义;且根据ROC曲线分析出临界值不同,文盲组MoCA得分诊断MCI的曲线下面积为0.946,临界值为17.5,灵敏度和特异度分别为85.71%和90.91%;小学组MoCA得分诊断MCI的曲线下面积为0.898,临界值为20.5,灵敏度和特异度分别为94.64%和72.73%;初中组MoCA得分诊断MCI的曲线下面积为0.983,临界值为21.5,灵敏度和特异度分别为96.72%和91.47%;高中及以上组MoCA得分诊断MCI的曲线下面积为0.984,临界值为22.5,灵敏度和特异度分别为90.00%和96.35%。结论: 湘潭市城乡社区居民中MCI患病率为28.22%,使用长沙版MoCA进行城乡社区老年人MCI筛查时需根据其受教育程度调整截断值,建议文盲组为17.5分;小学组为20.5分;初中组为21.5分;高中及以上组为22.5分。
Abstract
Objective To investigate the prevalence of mild cognitive impairment (MCI) in the elderly in the urban and rural communities of Xiangtan city, Hunan Province, and to explore the feasibility of Montreal cognitive assessment Changsha version (MoCA-CS) in the screening of mild cognitive impairment in the elderly in the communities of Xiangtan city. Method A multi-stage stratified cluster sampling method was used to conduct a questionnaire survey among the elderly over 65 years old in urban and rural communities of Xiangtan City, and the Changsha version of MoCA was adopted for cognitive function screening. Combined with clinical diagnosis and receiver operator characteristic curve (ROC) analysis, the ideal demarcation score of MCI screening was explored. Results Among 822 elderly people in the urban and rural communities of Xiangtan city, the positive rate of MCI screening was 28.22%. According to ROC curve analysis, the area under the curve of MoCA score for the differential diagnosis of MCI was 0.945, the critical value was 21.5, the sensitivity and specificity were 95.67% and 82.06%, respectively. There were significant differences in MoCA scores between people with different education levels; According to the ROC curve analysis, the area under the curve of MoCA score for the diagnosis of MCI in the illiterate group was 0.946, the cut-off value was 17.5, and the sensitivity and specificity were 85.71% and 90.91%, respectively. In primary school group, the area under the curve of MoCA score for the diagnosis of MCI was 0.898, the critical value was 20.5, and the sensitivity and specificity were 94.64% and 72.73%, respectively. The area under the curve of MoCA score for the diagnosis of MCI in the junior high school group was 0.983, the critical value was 21.5, the sensitivity and specificity were 96.72% and 91.47%, respectively. The area under the curve of MoCA score for the diagnosis of MCI in high school and above group was 0.984, the critical value was 22.5, and the sensitivity and specificity were 90.00% and 96.35%, respectively. Conclusions The prevalence of MCI is high in the residents of the urban and rural communities of Xiangtan city. The cut-off value of MoCA Changsha version should be adjusted according to the education level when used in the screening of the elderly in the urban and rural communities of Xiangtan City.
关键词
长沙版蒙特利尔认知评估量表 /
社区 /
轻度认知功能障碍 /
筛查
Key words
Montreal cognitive assessment Changsha version (MoCA-CS) /
community /
mild cognitive impairment /
screening
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基金
国家自然科学基金面上项目（81971086）; 湖南省卫健委科研项目（20200331）; 湖南省发育生物学与生物育种优势特色学科群交叉研究项目（2022XKQ0205）; 湖南师范大学基层教学组织建设项目（202101003015）
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