【摘要】 目的:探讨老年快速认知筛查量表(quick cognitive screening scale for elderly,QCSS-E)在社区老年人群中筛查轻度认知功能障碍(mild cognitive impairment,MCI)的分界值。方法:采用QCSS-E对社区223名60岁及以上的老年人进行MCI筛查,同时采用金标准进行临床诊断,根据ROC曲线评估QCST-E筛查MCI的整体性能及理想划界分。结果:223名老人中,确诊为正常老人(NC)160名、MCI42例、轻度痴呆21例,分别占71.75%、18.83%和9.42%;3组QCSS-E得分分别为(77.84±4.69)分、(70.31±3.94)分、(62.14±4.68)分,差异具有统计学意义(P<0.01)。当受试者文化程度分别为小学、初中及以上时,QCST-E筛查MCI/NC、轻度痴呆/MCI的最佳临界分为72、67分和73、68分,以该临界分采用QCSS-E筛查MCI/NC及轻度痴呆/MCI的灵敏度、特异度分别为88.1%、90%和90.48%、90.48%,筛查结果和临床诊断一致性检验Kappa值分别为0.680、0.791。结论:QCSS-E根据不同文化程度的分界值对老年人进行MCI筛查具有良好的灵敏度和特异度,其结果和临床诊断一致性较高,适宜基层医疗单位在社区老年人中推广应用。更多还原

【Abstract】 Objective: To investigate the cut off value of the quick cognitive screening scale for elderly( QCSS-E) in screening of elderly with mild cognitive impairment( MCI) in community. Method: 223 people at the age of 60 years or older from living in community were assessed using QCSS-E,and clinical diagnosed according to the gold standard. Based on ROC analysis,we explored QCSS-E’s optimal cut off value for detecting MCI and mild dementia. Results: Among the 223 elderly,there were 160 with normal cognitive,42 cases of MCI and 21 cases of mild dementia,and the three groups showed significant difference on QCSS-E[( 77. 84 ±4. 69),( 70. 31 ± 3. 94),( 62. 14 ± 4. 68),respectively,P < 0. 01]. The cut off value was 72 points in judging MCI and NC,67 points in judging mild dementia and MCI in subjects with primary school education,and 73 points,68 points in subjects with junior high school and above culture. Based on the above cut off value,the sensitivity and specificity that screening MCI/NC and mild dementia/MCI was 88. 1%,90% and 90. 48%,90. 48% respectively. The consistency between clinical diagnose results and screening results by QCSS-E was good. Conclusion: QCSS-E has good consistency with clinical diagnosis,and it is suitable for the grass-roots medical personnel to screen the cognitive impairment patient in the elder.更多还原