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Comparison of the Validity of Screening Tests for Dementia and Mild Cognitive Impairment of the Elderly in a Community:K-MMSE, MMSE-K, MMSE-KC, and K-HDS

Other Title
치매 및 경도인지장애에 대한 인지선별검사 4종의 타당도 비교
Authors
이, 강수; 정, 해관; 오, 병훈; 홍, 창형
Citation
Journal of Korean Neuropsychiatric Association, 48(2):61-69, 2009
Journal Title
Journal of Korean Neuropsychiatric Association; 신경정신의학
ISSN
1015-48172289-0963
Abstract
치매선별검사는 가급적 동일한 도구를 사용하는 것이 바람직하다. 이 중 간이정신상태검사 및 하세가와 치매척도는 국제적으로 가장 널리 사용되고 있는 도구로 인지장애의 진단, 치매의 아형 구분 등에 사용하는 데는 무리가 있으나 기본적인 선별검사로는 우수한 검사이다. 그간 국내에서 여러가지 형태로 개발되었으나 기본적으로 검사 간에 큰 차이가 없으므로 혼용할 수 있다. 그러나 환자 개인에 대한 추적, 기관 간 비교 등을 위해서는 가급적 한 가지 형태로 통일하여 사용하고 동일한 검사를 사용하지 못한 경우일지라도 정상규준은 동일한 표본에서 산출된 규준을 사용하는 것이 바람직하다. 한편 치매선별검사 4종은 경도인지장애를 선별하 는 데에는 유용하지 않았다.

Objectives: The authors have evaluated the validity of four currently used screening tools of cognitive function in Korea for dementia and mild cognitive impairment in a community elderly population.



Methods: We screened 5,085 non-randomly sampled elderly over age 60 in the Gwangju city, Gyeonggi Province. Among those, 927 persons were examined further for evidence of dementia and mild cognitive impairment (MCI). A baseline questionnaire on sociodemographic characteristics and four major screening tests (K-MMSE, MMSE-K, MMSE-KC, and K-HDS) were administered. For the evaluation of validity, we have analyzed the ROC curve and calculated the sensitivity and specificity of each test at its optimal cutoff points.



Results: ROC analysis of the 3 MMSEs and K-HDS has shown that area under the curve (AUC) was between 0.897 and 0.923 for dementia. Sensitivity and specificity were 0.768 and 0.870, respectively, when the cutoff line was set at 17/18 in K-MMSE. The other two MMSEs had optimal cutoff lines at 16/17 with sensitivity of 0.768 and specificity more than 0.90. K-HDS had its optimal cutoff line at 18/19 with higher sensitivity (0.874) and lower specificity (0.755). Compared with dementia, the four screening tests showed poor validity on MCI. Sensitivity and specificity was in the range of 0.733-0.756 and 0.840-0.855, respectively.



Conclusion: The validity of the screening tools which are currently being used in Korea to screen for MCI was not significantly different among tests. Because of the difference in the population norm and z-score estimation, use of the common norm is advisable.
Keywords
치매알츠하이머병선별타당도역학지역사회DementiaAlzheimer’s diseaseScreeningValidityEpidemiologyCommunity
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Psychiatry & Behavioural Sciences
AJOU Authors
홍, 창형
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