相似性测验在诊断轻度认知损害和阿尔茨海默病的效用研究

Effect of similarities test in the diagnosis of mild cognitive impairment and Alzheimer's disease

摘要:

目的：分析相似性测验在识别轻度认知损害（mild cognitive impairment，MCI）和阿尔茨海默病(Alzheimer's disease，AD)的价值。方法：该研究纳入125例单纯遗忘型MCI、160例多领域损害遗忘型MCI患者，139例AD患者，132例正常对照者，均进行包含有相似性测验（similarities test，ST）的全套神经心理学测试，其中简易精神状态量表（Mini-mental State Examination，MMSE）和听觉词语测验（Auditory-verbal Learning Test, AVLT）用于初步筛查，根据筛查结果再进一步评估检查。相似性测验包含13个项目，每条项目按0、1、2三级计分，最高分26分。结果：4个测试组的总分进行比较，结果提示有统计学差异（r=0.15~0.47，P<0.01）。相似性测验得分与语言相关的测试如动物言语流畅性（Animal Fluency Test，AFT）、波士顿命名（Boston Naming Test，BNT）得分有显著相关性。相似性测验得分（26分制划界分12分）用于识别AD的ROC曲线下面积0.881（P<0.01，95%CI=0.842~0.920）。结论：13个项目的相似性测验可用于检测语言相关的认知功能和识别单纯遗忘型MCI、多领域损害遗忘型MCI和AD患者。

Abstract:

Objectives: To evaluate the value of similarities test (ST) in the diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD). Methods: One hundred and twenty-five patients with amnestic MCI-single domain (aMCI-SD), 160 patients with amnestic MCI-multiple domain (aMCI-MD), 139 AD patients, and 132 normal controls were all evaluated by a complete set of neuropsychological tests including ST. Among these tests, Mini-Mental State Examination and Auditory-Verbal Learning Test were used for preliminary screening, and further evaluation and examination were carried out according to the screening results.. The similarities test consisted of 13 items, and each item was scored at three levels: 0, 1 and 2, with a maximum score of 26. Results: The total scores of the four groups were then compared, and the results showed that there were significant differences (r = 0.15-0.47, P <0.01). ST scores were found to have a significant correlation with the scores of tests reflecting language function such as Animal Fluency Test and Boston Naming Test. The area under the ROC curve of ST score (total score: 26; cut-off score: 12) for the diagnosis of AD was 0.881 (95% confidence interval: 0.842-0.920, P <0.01). Conclusion: ST with 13 items can be used to test language-related cognitive function and is effective for identifying aMCI-SD, aMCI-MD, and AD patients.