关键词: 轻度认知障碍, 全科医生认知功能评估量表, 蒙特利尔认知评估基础量表

Abstract: Background　There are no effective treatments for dementia，a disease with a heavy burden，which is becoming increasingly prevalent among the rapidly growing aging population. As a pre-stage of dementia，mild cognitive impairment（MCI）has attracted wide attention，but the screening for it using scales has not been popularized due to various scale limitations. So it is very important to find a simple tool suitable for screening for MCI in primary care. Objective　To explore the value of the Chinese version of the General Practitioner Assessment of Cognition（GPCOG-C） in screening for MCI in primary care. Methods　By use of simple random sampling and systematic sampling，860 cases were selected from 4 962 physical examinees（≥ 60 years old）in Shanghai to attend a questionnaire survey conducted from May to July 2020 by unified trained college student volunteers using a demographic questionnaire developed by our research group，four MCI assessment scales〔Montreal Cognitive Assessment Basic（MoCA-B），Activities of Daily Living（ADL） Scale，Dementia Rating Scale（CDR）and GPCOG-C〕. MCI was diagnosed using the criteria proposed by Petersen et al. Participants with MCI were matched 1:1 to those with normal cognitive function randomly in terms of age，sex，and years of education using SPSS software to run a comparative analysis. ROC curve of the GPCOG-C in screening for MCI was plotted to examine its cut-off threshold，sensitivity，specificity，positive and negative predictive values. Spearman's rank correlation analysis was used to measure the reliability of the GPCOG-C. The internal consistency of the scale was measured by Cronbach's α. Results　Altogether，812 cases completed the survey，and 192 of them（24.27%） were assessed to have MCI. 187 MCI cases（MCI group） and 187 matched cases of normal cognitive function（control group）were finally included. Compared with the criteria for MCI defined by Petersen et al，the gold standard，the GPCOG-C was found by ROC analysis to have a maximal Youden index of 0.43. When the cut-off threshold was determined as 12 points，the sensitivity，specificity，positive predictive value and negative predictive value of the GPCOG-C were 70.05%，69.52%，69.68% and 69.89%，respectively. The control group had higher mean scores of MoCA-B and GPCOG（P<0.05）. The mean time used for completing the MOCA-B differed significantly between the groups（P<0.05），but that used for completing the GPCOG-C did not（P>0.05）. MCI group had statistically significantly lower mean scores of time orientation，clock drawing，message，memory（first name，last name，city，road，house number），patient part，informed part and total score（P<0.05）. The inter-item correlation analysis of the GPCOG-C showed that the correlation between clock drawing and memory（last name） was negative and the correlation between clock drawing and informant section was negative. Other items were positively correlated to a certain extent，and the correlation coefficient r ranged 0.021 to 0.836. The Cronbach's α of GPCOG-C was 0.78. The mean time used for completing the MoCA-B was longer than that used for completing the GPCOG-C in all participants（P<0.001）. And the mean total GPCOG-C score was positively correlated with the mean MoCA-B score（rs=0.484，P<0.001）. Conclusion　The reliability and validity of the GPCOG-C have proved to be reasonable，suggesting that it may used for the screening for MCI in primary care.

Key words: Mild cognitive impairment, General Practitioner Assessment of Cognition, Montreal Cognitive Assessment Basic