使用美国国家阿尔茨海默病协调中心统一数据集的蒙特利尔认知评估的敏感性和特异性:16309名参与者的回顾性分析。

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY
Youssef A Ismail, Huda A Auf, Shahd A Sadik, Nada M Ahmed, Yasmeen Ali
{"title":"使用美国国家阿尔茨海默病协调中心统一数据集的蒙特利尔认知评估的敏感性和特异性:16309名参与者的回顾性分析。","authors":"Youssef A Ismail, Huda A Auf, Shahd A Sadik, Nada M Ahmed, Yasmeen Ali","doi":"10.1186/s12883-025-04190-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Neurodegenerative diseases (NDDs), like Alzheimer's disease, are characterized by progressive cognitive decline, with limited effective treatments available. Several screening tools are available for diagnosing various types of dementia, including the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Dementia Rating Scale (DRS).</p><p><strong>Objective: </strong>This study aims to evaluate the sensitivity and specificity of MoCA to determine its suitability as a screening tool.</p><p><strong>Methods: </strong>This study analyzed data from participants aged 55 and older, recruited from U.S. Alzheimer's Disease Research Centers (ADRCs), using a National Alzheimer Coordinating Center Uniformed Data Set (NACC-UDS). Participants were classified based on patient records into demented and non-demented groups, with the non-demented group further categorized into those with normal cognition and cognitive impairment (CI). This analysis examines the correlation between these classifications and MoCA scores.</p><p><strong>Results: </strong>This study utilized an initial dataset of 188,700 participant records from NACC. After applying inclusion criteria, 16,309 participants were included. The participants had complete diagnostic information, clinician-conducted cognitive assessments, and MoCA scores. The participants were categorized into three groups: 7,624 with no cognitive impairment (NoCI), 4,893 with CI, and 3,792 with dementia. This study focused on MoCA scores, revealing significant differences among diagnostic groups. ROC analysis demonstrated the MoCA's strong diagnostic capability, with AUC values significantly above 0.5 (P <.001). Sensitivity and specificity were calculated in at the literature-recommended cutoff scores of 26 and 21, while the optimal cutoff scores were identified as (< 24) for detecting MCI and (< 21) for dementia based on the Youden index in reference to individuals with no cognitive impairment. Although PPV was generally low, the high NPV across comparisons underscores the MoCA's effectiveness in ruling out cognitive impairment.</p><p><strong>Conclusion: </strong>The study confirms MoCA as an effective tool for detecting dementia, showing 83% sensitivity and 82% specificity at a cutoff value of 21. With a high NPV of 94%, MoCA is particularly reliable for ruling out dementia. Its ability to detect MCI is moderate, with a sensitivity of 77.3% at cutoff of 24 among normal population.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"381"},"PeriodicalIF":2.2000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455826/pdf/","citationCount":"0","resultStr":"{\"title\":\"Sensitivity and specificity of the Montreal cognitive assessment using U.S. National alzheimer coordinating centre uniform data set: a retrospective analysis of 16,309 participants.\",\"authors\":\"Youssef A Ismail, Huda A Auf, Shahd A Sadik, Nada M Ahmed, Yasmeen Ali\",\"doi\":\"10.1186/s12883-025-04190-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Neurodegenerative diseases (NDDs), like Alzheimer's disease, are characterized by progressive cognitive decline, with limited effective treatments available. Several screening tools are available for diagnosing various types of dementia, including the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Dementia Rating Scale (DRS).</p><p><strong>Objective: </strong>This study aims to evaluate the sensitivity and specificity of MoCA to determine its suitability as a screening tool.</p><p><strong>Methods: </strong>This study analyzed data from participants aged 55 and older, recruited from U.S. Alzheimer's Disease Research Centers (ADRCs), using a National Alzheimer Coordinating Center Uniformed Data Set (NACC-UDS). Participants were classified based on patient records into demented and non-demented groups, with the non-demented group further categorized into those with normal cognition and cognitive impairment (CI). This analysis examines the correlation between these classifications and MoCA scores.</p><p><strong>Results: </strong>This study utilized an initial dataset of 188,700 participant records from NACC. After applying inclusion criteria, 16,309 participants were included. The participants had complete diagnostic information, clinician-conducted cognitive assessments, and MoCA scores. The participants were categorized into three groups: 7,624 with no cognitive impairment (NoCI), 4,893 with CI, and 3,792 with dementia. This study focused on MoCA scores, revealing significant differences among diagnostic groups. ROC analysis demonstrated the MoCA's strong diagnostic capability, with AUC values significantly above 0.5 (P <.001). Sensitivity and specificity were calculated in at the literature-recommended cutoff scores of 26 and 21, while the optimal cutoff scores were identified as (< 24) for detecting MCI and (< 21) for dementia based on the Youden index in reference to individuals with no cognitive impairment. Although PPV was generally low, the high NPV across comparisons underscores the MoCA's effectiveness in ruling out cognitive impairment.</p><p><strong>Conclusion: </strong>The study confirms MoCA as an effective tool for detecting dementia, showing 83% sensitivity and 82% specificity at a cutoff value of 21. With a high NPV of 94%, MoCA is particularly reliable for ruling out dementia. Its ability to detect MCI is moderate, with a sensitivity of 77.3% at cutoff of 24 among normal population.</p>\",\"PeriodicalId\":9170,\"journal\":{\"name\":\"BMC Neurology\",\"volume\":\"25 1\",\"pages\":\"381\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455826/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12883-025-04190-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12883-025-04190-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:神经退行性疾病(ndd),如阿尔茨海默病,以进行性认知能力下降为特征,有效治疗方法有限。有几种筛查工具可用于诊断各种类型的痴呆,包括蒙特利尔认知评估(MoCA),迷你精神状态检查(MMSE)和痴呆评定量表(DRS)。目的:本研究旨在评价MoCA的敏感性和特异性,以确定其作为筛查工具的适用性。方法:本研究使用国家阿尔茨海默病协调中心统一数据集(NACC-UDS)分析了从美国阿尔茨海默病研究中心(adrc)招募的55岁及以上参与者的数据。参与者根据患者记录分为痴呆组和非痴呆组,非痴呆组进一步分为认知正常组和认知障碍组(CI)。本分析检验了这些分类与MoCA评分之间的相关性。结果:本研究利用了来自NACC的188,700名参与者记录的初始数据集。应用纳入标准后,共纳入16309名受试者。参与者有完整的诊断信息、临床医生进行的认知评估和MoCA评分。参与者被分为三组:7624人无认知障碍(NoCI), 4893人有认知障碍(CI), 3792人有痴呆。本研究的重点是MoCA评分,揭示了诊断组之间的显著差异。ROC分析显示MoCA具有较强的诊断能力,AUC值显著高于0.5 (P)。结论:本研究证实MoCA是一种检测痴呆的有效工具,在截断值为21时,其灵敏度为83%,特异性为82%。MoCA的净现值高达94%,在排除痴呆方面尤其可靠。它检测MCI的能力是中等的,在正常人群中,在临界值为24时的灵敏度为77.3%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sensitivity and specificity of the Montreal cognitive assessment using U.S. National alzheimer coordinating centre uniform data set: a retrospective analysis of 16,309 participants.

Background: Neurodegenerative diseases (NDDs), like Alzheimer's disease, are characterized by progressive cognitive decline, with limited effective treatments available. Several screening tools are available for diagnosing various types of dementia, including the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Dementia Rating Scale (DRS).

Objective: This study aims to evaluate the sensitivity and specificity of MoCA to determine its suitability as a screening tool.

Methods: This study analyzed data from participants aged 55 and older, recruited from U.S. Alzheimer's Disease Research Centers (ADRCs), using a National Alzheimer Coordinating Center Uniformed Data Set (NACC-UDS). Participants were classified based on patient records into demented and non-demented groups, with the non-demented group further categorized into those with normal cognition and cognitive impairment (CI). This analysis examines the correlation between these classifications and MoCA scores.

Results: This study utilized an initial dataset of 188,700 participant records from NACC. After applying inclusion criteria, 16,309 participants were included. The participants had complete diagnostic information, clinician-conducted cognitive assessments, and MoCA scores. The participants were categorized into three groups: 7,624 with no cognitive impairment (NoCI), 4,893 with CI, and 3,792 with dementia. This study focused on MoCA scores, revealing significant differences among diagnostic groups. ROC analysis demonstrated the MoCA's strong diagnostic capability, with AUC values significantly above 0.5 (P <.001). Sensitivity and specificity were calculated in at the literature-recommended cutoff scores of 26 and 21, while the optimal cutoff scores were identified as (< 24) for detecting MCI and (< 21) for dementia based on the Youden index in reference to individuals with no cognitive impairment. Although PPV was generally low, the high NPV across comparisons underscores the MoCA's effectiveness in ruling out cognitive impairment.

Conclusion: The study confirms MoCA as an effective tool for detecting dementia, showing 83% sensitivity and 82% specificity at a cutoff value of 21. With a high NPV of 94%, MoCA is particularly reliable for ruling out dementia. Its ability to detect MCI is moderate, with a sensitivity of 77.3% at cutoff of 24 among normal population.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信