この患者さんは認知症ですか?
Tracey Holsinger1, Janie Deveau, Malaz Boustani
1Department of Psychiatry, Durham VA Medical Center, Durham, NC, USA. tracey.holsinger@va.gov
JAMA
|June 7, 2007
まとめ
短期的な認知スクリーニングテストは,初等医療における認知症の診断に役立ちます. The Memory Impairment Screenとインフォマントレポートは,高齢者の認知障害を検出する有望なことを示しています.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- 神経学 神経学とは
- プライマリーケア医療 プライマリーケア医療
背景:
- 米国では何百万人もの人々が認知症や記憶障害を経験しています.
- 認知障害の早期発見は,認知症の早期診断に不可欠です.
- 簡潔なスクリーニングツールは,初等保健施設で役立ちます.
研究 の 目的:
- プライマリケアにおける簡潔な認知スクリーニングの実用性と正確性に関する文献をレビューする.
- 認知症の認知スクリーニングツールに関する以前のレビューを更新する.
主な方法:
- MEDLINEとpsychINFOのデータベース (2000-2006年) で検索しました.
- 認知症の診断が確認された60歳以上の患者の研究も含まれています.
- 25の異なるスクリーニングツールを使用して,適格性および品質のための29の研究を評価しました.
主要な成果:
- 38のユニークな楽器/研究組み合わせを評価しました.
- ミニメンタルステート試験 (MMSE) は,6.3 (陽性) と0.19 (陰性) の中位確率比 (LRs) を示した.
- メモリー障害スクリーン (4分) はLRsが33 (陽性) と0.08 (陰性) であった. 情報提供者の報告では,認知症のLRは6.5であった.
結論:
- 臨床医は,患者集団と人口統計スコア効果の認識に基づいて,プライマリスクリーニングツールを選択する必要があります.
- 特定の状況のための二次ツールを追加することを検討してください.
- 時計描画テストは有用ですが,適切なスコア付けを必要とし,軽度の障害を見逃す可能性があります.
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