| 许哲源,何梦霏,王梦寰,林枫,江钟立.中文版卒中认知评估量表在非卒中人群中的应用研究[J].中国康复,2025,40(5):289-295 |
| 中文版卒中认知评估量表在非卒中人群中的应用研究 |
| Clinical application of Chinese version of cognitive assessment scale for stroke patients in a non-stroke population |
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| DOI：10.3870/zgkf.2025.05.006 |
| 中文关键词: 卒中认知评估量表 非卒中人群 轻度认知障碍 认知功能筛查 |
| 英文关键词: cognitive assessment scale for stroke patients non-stroke populations mild cognitive impairment cognitive function screening |
| 基金项目:国家重点研发计划（2020YFC2008505） |
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| 中文摘要: |
| 目的：探讨中文版卒中认知评估量表（C-CASP）对非卒中人群认知功能筛查的有效性和适用性，丰富现有的认知功能筛查工具。方法：分别采用简易精神状态量表（MMSE）、蒙特利尔认知评估量表（MoCA）和C-CASP评估109名非卒中一般人群的认知功能。绘制受试者工作特征曲线（ROC）并计算曲线下面积（AUC），采用Youden指数、Pearson相关系数、Kappa值分析量表的应用价值。结果：C-CASP最佳截断值取34分时，敏感性为76.9%，特异性为89.2%，AUC=0.905（95%CI：0.831~0.978，P<0.001）。C-CASP、MMSE和MoCA的认知异常检出率分别为19.3%、4.6%和23.9%。3种量表在评估用时上C-CASP用时短于MoCA而长于MMSE（P<0.01）。C-CASP与MMSE、MoCA总分的相关系数分别为0.789和0.796（均P<0.001）。MMSE和MoCA总分的相关系数为0.726（P<0.001）。C-CASP与MoCA的检出结果显示出较好的一致性（Kappa值=0.703），C-CASP与MMSE的一致性则一般（Kappa值=0.335）。线性回归结果显示年龄、受教育年限是认知量表得分的影响因子。C-CASP中“命名”、“理解能力”和“二分线段”条目、MMSE的“记忆力”条目和MoCA的“定向”条目在年龄和受教育年限分组间的得分比较无统计学差异，3种量表的其余条目青年组（≤44岁）得分显著高于中老年组（>44岁）（P<0.05，0.01），低教育水平组（≤12年）得分显著低于高教育水平组（>12年）（P<0.05，0.01）。结论：C-CASP以34分为截断值可以有效检出非卒中人群中的轻度认知障碍（MCI）个体，3种量表的认知阈检测各有侧重，C-CASP适用于低学历中老年非卒中人群的认知功能筛查。 |
| 英文摘要: |
| Objective: To investigate the applicability of Chinese version of cognitive assessment scale for stroke patients (C-CASP) in the cognitive function screening for non-stroke populations, improving the cognitive function screening system. Methods: C-CASP, mini-mental state examination (MMSE), and Montreal cognitive assessment (MoCA) were used to evaluate the cognitive function in 109 non-stroke general population. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC), Youden index, Pearson correlation coefficient, and Kappa value were calculated to analyze the application value of these scales. Results: When the optimal cutoff value of C-CASP was set at 34 points, the sensitivity was 76.9%, the specificity was 89.2%, and AUC was 0.905 (95% CI: 0.831-0.978, P<0.001). The detection rates for cognitive impairment using C-CASP, MMSE, and MoCA were respectively 19.3%, 4.6%, and 23.9%. There were differences in assessment time among the three scales (P<0.01). The correlation coefficients between the total scores of C-CASP and MMSE and MoCA were 0.789 and 0.796, respectively (all P<0.001). The correlation coefficient between the total score of MMSE and MoCA was 0.726 (P<0.001). The detection results of C-CASP and MoCA showed good agreement (Kappa value=0.703), while the agreement between C-CASP and MMSE was moderate (Kappa value=0.335). Linear regression analysis indicated that age and years of education affected the scores of cognitive scales. Scores for the “Naming”, “Comprehension” and “Line Bisection” items of the C-CASP, the “Memory” item of the MMSE and the “Orientation” item of the MoCA, showed no statistically significant differences across age and years of education groups. However, for the remaining items, younger adults (≤44 years old) scored significantly higher than older adults (>44 years old) (P<0.05，0.01), and individuals with higher education levels (>12 years) scored significantly higher than those with lower education levels (≤12 years) (P<0.05，0.01). Conclusion: Using a cutoff score of 34, C-CASP can effectively identify individuals with mild cognitive impairment (MCI) in non-stroke populations. The cognitive thresholds vary among the three scales, each holding its specific emphasis. The C-CASP is appropriate for cognitive function screening in middle-aged and elderly non-stroke populations with lower levels of education. |
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