这个病人有痴呆症吗?
Tracey Holsinger1, Janie Deveau, Malaz Boustani
1Department of Psychiatry, Durham VA Medical Center, Durham, NC, USA. tracey.holsinger@va.gov
JAMA
|June 7, 2007
概括
简短的认知查测试有助于在初级保健中诊断痴呆症. 记忆障碍屏幕和信息员报告显示,在老年人中检测认知障碍是有前途的.
科学领域:
- 老年学是指老年学的学科.
- 神经学 神经学
- 主要护理医学 医疗保健
背景情况:
- 美国有数百万人患有痴呆症或记忆障碍.
- 早期发现认知障碍对于及时诊断痴呆症至关重要.
- 简短的查工具可以在初级保健机构提供帮助.
研究的目的:
- 审查关于初级保健中简要认知查仪器的实用性和准确性的文献.
- 更新以前关于痴呆症认知查工具的评论.
主要方法:
- 在 MEDLINE 和 psycINFO 数据库 (2000-2006 年) 进行了搜索.
- 包括60岁以上的老年痴呆症诊断确认患者的研究.
- 评估了29项研究,使用了25种不同的资格和质量选工具.
主要成果:
- 评估了38种独特的仪器/研究组合.
- 迷你心理状态检查 (MMSE) 的中位数概率比 (LRs) 为6.3 (阳性) 和0.19 (负).
- 记忆障碍屏幕 (4分钟) 的LR为33 (阳性) 和0.08 (阴性);信息员报告的LR为痴呆症的6.5.
结论:
- 临床医生应根据患者人群和对人口统计学评分效应的认识选择初级查工具.
- 考虑为特定情况添加二次工具.
- 时钟绘图测试可能是有用的,但需要适当的评分,可能会错过轻度损伤.
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