蒙特利尔认知评估在2型糖尿病患者中检测认知障碍的有效性
Anu Gupta1, Alpesh Goyal2, Roopa Rajan1
1Department of Neurology, All India Institute of Medical Sciences, New Delhi, 110029, India.
概括
对患有2型糖尿病 (T2D) 的老年人进行轻度认知障碍 (MCI) 的查至关重要. 较低的蒙特利尔认知评估 (MoCA) 分数<21最大限度地提高了T2D患者MCI的诊断准确性.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
- 老年病的医生 老年病的医生
背景情况:
- 对于患有2型糖尿病 (T2D) 的老年人 (≥60-65岁) 建议进行认知障碍查,因为这对糖尿病管理有影响.
- 蒙特利尔认知评估 (MoCA) 被广泛用于检测一般人群中的轻度认知障碍 (MCI),但其在T2D中的有效性需要建立.
研究的目的:
- 评估蒙特利尔认知评估 (MoCA) 的诊断有效性,以检测2型糖尿病 (T2D) 的老年人轻度认知障碍 (MCI).
- 为了确定MoCA的最佳切断分数,在这个特定人群中识别MCI.
主要方法:
- 给267名T2D患者 (≥60岁) 和120名对照人服用MoCA和神经心理电池.
- 定义的MCI基于表现≥1.0 SD低于控制在认知领域的功能活动保留下来.
- 评估了MoCA在MCI诊断的各种截止点上的区分有效性.
主要成果:
- 39%的T2D参与者通过详细测试满足了MCI标准.
- 标准的MoCA切线 (<26) 显示高灵敏度 (94.2%),但特异性低 (29.5%).
- 一个MoCA切线<21显示了最高的诊断准确度 (74.9%),优异的特异性 (91.4%) 和良好的预测值.
结论:
- 标准的MoCA切线 (<26) 对T2D患者来说是不理想的,可能导致不必要的转诊.
- 建议较低的MoCA切断值<21以最大限度地提高MCI的诊断准确度,在T2D的老年人中.
- 这一发现可以提高对T2D患者的记忆诊所转诊的效率.
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