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首页> 外文期刊>eNeurologicalSci >Evaluation of cognitive impairment in elderly population with hypertension from a low-resource setting: Agreement and bias between screening tools
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Evaluation of cognitive impairment in elderly population with hypertension from a low-resource setting: Agreement and bias between screening tools

机译：资源贫乏地区老年人高血压认知障碍的评估：筛查工具之间的一致性和偏倚

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Introduction The evaluation of cognitive impairment in adulthood merits attention in societies in transition and especially in people with chronic diseases. Screening tools available for clinical practice and epidemiological studies have been designed in high-income but not in resource-constrained settings. The aim of this study was to assess the agreement and bias of three common tools used for screening of cognitive impairment in people with hypertension: the modified Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Leganés Cognitive Test (LCT). Methods A cross-sectional study enrolling participants with hypertension from a semi-urban area in Peru was performed. The three screening tools for cognitive impairment were applied on three consecutive days. The prevalence of cognitive impairment was calculated for each test. Pearson's correlation coefficients, Bland-Altman plots, and Kappa statistics were used to assess agreement and bias between screening tools. Results We evaluated 139 participants, mean age 76.5 years (SD ± 6.9), 56.1% females. Cognitive impairment was found in 28.1% of individuals using LCT, 63.3% using MMSE, and 100% using MoCA. Correlation coefficients ranged from 0.501 between LCT and MoCA, to 0.698 between MMSE and MoCA. Bland-Altman plots confirmed bias between screening tests. The agreement between MMSE and LCT was 60.4%, between MMSE and MoCA was 63.3%, and between MoCA and LCT was 28.1%. Conclusions Three of the most commonly used screening tests to evaluate cognitive impairment showed major discrepancies in a resource-constrained setting, signaling towards a sorely need to develop and validate appropriate tools. Highlights ? Cognitive impairment in elderly with hypertension can range between 28% and 100% according to the screening tool utilized. ? Three of the most common tools to evaluate cognitive impairment have poor agreement in older people with hypertension. ? The agreement between cognitive impairment tests is lower among persons with greater scores.
机译：引言对成年期认知障碍的评估值得转型社会特别是慢性病患者的关注。在高收入人群中设计了可用于临床实践和流行病学研究的筛查工具，但在资源有限的环境中却没有。这项研究的目的是评估用于筛查高血压患者认知障碍的三种常用工具的一致性和偏倚性：改良的小精神状态检查（MMSE），蒙特利尔认知评估（MoCA）和Leganés认知测试（LCT）。方法进行了一项横断面研究，招募了来自秘鲁半城市地区的高血压参与者。连续三天应用了三种认知障碍筛查工具。计算每个测试的认知障碍患病率。皮尔逊相关系数，Bland-Altman图和Kappa统计量用于评估筛选工具之间的一致性和偏差。结果我们评估了139名参与者，平均年龄76.5岁（SD±6.9），女性为56.1％。使用LCT，23.3％使用MMSE和100％使用MoCA时，发现认知障碍的个体为28.1％。相关系数的范围从LCT和MoCA之间的0.501到MMSE和MoCA之间的0.698。 Bland-Altman图证实了筛选测试之间的偏差。 MMSE与LCT之间的一致性为60.4％，MMSE与MoCA之间的一致性为63.3％，MoCA与LCT之间的一致性为28.1％。结论三种最常用的评估认知障碍的筛查测试表明，在资源有限的情况下存在重大差异，这表明迫切需要开发和验证合适的工具。强调 ？根据所使用的筛查工具，高血压老年人的认知障碍可能在28％至100％之间。 ？评估认知障碍的三种最常用工具在老年人高血压中的一致性较差。 ？得分较高的人认知障碍测试之间的一致性较低。

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