경도인지장애에서 몬트리올 인지평가 척도의 유용성
Usefulness of the Montreal Cognitive Assessment in Mild Cognitive Impairment
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초록
경도인지장애의 진단에 대한 몬트리올 인지평가의 유용성, 소항목별 차이, 그리고 이에 영향미치는 요인을 알아보기 위해서 정상대조군(N=25), 경도인지장애군(N=27), 알츠하이머형치매군(N=26)을 대상으로 MoCAK와MMSE-K 검사를 실시하고, 비교 분석하여 다음의 결과를 얻었다. 1) 절취점을 23/24로 취했을 때 MCI를 진단하는MoCA-K의 민감도는 70%, 특이도는 92%였고, 절취점을 23/24로 취했을 때 MCI를 진단하는 MMSE-K의민감도는 11%, 특이도는 96%였다. 전반적으로, MoCAK는MMSE-K 보다 민감도가 더 높았고, 특이도는비슷하였다. 2) MoCA-K는 MMSE-K 보다 더 많은 소항목에서차이를 보였으며, 특히 주의력과 추상력 항목에서 유의한 차이가 있었다(각각 p<0.001). 3) MoCA-K 전체 점수는 MMSE-K 전체점수와 순상관관계(γ=0.879, p<0.01)가 있었으며, 연령(γ=-0.550, p<0.01)과 역상관관계, 교육수준(γ=0.489,p<0.01)과 순상관관계가 있었다. 결론적으로, 경도인지장애의 진단에는 MoCA 검사가MMSE 보다 더 유용하다. 그러나, MMSE와 마찬가지로 연령, 교육수준에 따라서 오차가 생길 수 있다.
Abstract
Objectives：This study was tried to know usefulness of the Montreal Cognitive Assessment(MoCA) to detect mild cognitive impairment(MCI), to identify any differences according to items, and to disclose variables associated with MoCA. Methods：The MoCA-K(Korean Version of the Montreal Cognitive Assessment) and the MMSE-K(Korean Version of the Mini-Mental State Examination) were performed to normal controls(N=25), patients with MCI(N=27), and patients with dementia of the Alzheimer’s type(N=26). Results：1) At cut-off of 23/24, sensitivity of the MoCA-K to detect MCI was 70% and specificity was 92%. While sensitivity of the MMSE-K was 11%, and specificity was 96%. In general, the MoCA-K had higher sensitivity than the MMSE-K, while specificity was similar. 2) There were more differences in items of the MoCA than those of the MMSE, especially in attention and abstraction(p<0.001, respectively). 3) Total scores of the MoCA-K had positive correlation with total scores of the MMSE-K(γ=0.879, p<0.01) and education(γ=0.489, p<0.01), and negative correlation with age(γ=-0.550, p<0.01). Conclusion：The MoCA test seemed to be more useful than the MMSE to detect mild cognitive impairment. However, bias from age and educational level might affect the test results like MMSE.
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