Avaliação do Desempenho do Teste de Rastreio “Memory Impairment Screen” para Demência na Doença de Alzheimer
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2017-07-14
Autores
Petrillo, Sandra Lúcia
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Universidade Estadual Paulista (Unesp)
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Objetivo: Avaliar desempenho do teste de rastreio Memory Impairment Screen (MIS) para a triagem diagnóstica da Demência na Doença de Alzheimer (DDA). Casuística e método: Estudo de acurácia realizado no Ambulatório de Geriatria do Centro de Saúde Escola da Faculdade de Medicina de Botucatu – Unesp. Casuística de 126 pacientes idosos, sendo aplicado o teste de avaliação cognitiva MIS, utilizando-se como padrão ouro os critérios diagnósticos da DDA propostos por Frota. O valor diagnóstico foi analisado pelo cálculo da sensibilidade, especificidade, valores preditivos (positivo e negativo) e razão de verossimilhança positiva e negativa. A curva ROC foi traçada para contribuir na avaliação do desempenho do MIS no diagnóstico da DDA. Resultados: Foram avaliados 126 idosos com média de idade de 71,6 + 7,8 anos, maioria do sexo feminino (65,9%) e com 1 a 4 anos de estudo (40%). A presença do diagnóstico de Doença de Alzheimer foi observada em 18 (14,3%) dos idosos avaliados. O teste de rastreio cognitivo pelo MIS apresentou valor de sensibilidade de 72,2%, especificidade de 83,3%, valor preditivo positivo de 41,9% e negativo de 94,7% e razões de verossimilhanças positiva de 433 e negativa de 33,3. A área sob a curva ROC foi de 0,78 (IC 95%, 0,65-0,9). Conclusão: O presente estudo evidenciou a aplicabilidade do teste MIS e sua eficácia no diagnóstico das alterações cognitivas em pacientes idosos, com valores significativos de sensibilidade e especificidade; apresentou vantagens de rapidez, fácil aplicabilidade e interpretação; independente de cultura, linguagem e escolaridade. O MIS oferece vantagens importantes como teste de rastreio para uso em cuidados primários a saúde, sendo necessário estudos complementares que possam indicar o uso isolado deste teste para exclusão de demência.
Objective: To evaluate the performance of the Memory Impairment Screen (MIS) for the diagnostic screening of Dementia in Alzheimer's Disease (AD). Methods: Accuracy study performed at the Geriatrics Outpatient Clinic of the School Health Center of Botucatu Medical School - Unesp. A total of 126 elderly patients were enrolled, and the MIS cognitive evaluation test was applied, using the AD diagnostic criteria proposed by Frota as the gold standard. The diagnostic value was analyzed by the calculation of sensitivity, specificity, predictive values (positive and negative) and positive and negative likelihood ratio. The ROC curve was drawn to contribute to the evaluation of MIS performance in the diagnosis of AD. Results: A total of 126 elderly individuals with a mean age of 71.6 ± 7.8 years, most of them female (65.9%) and 1 to 4 years of education (40%) were evaluated. The presence of the diagnosis of Alzheimer's disease was observed in 18 (14.3%) of the elderly evaluated. The MIS cognitive screening test showed a sensitivity of 72.2%, specificity of 83.3%, positive predictive value of 41.9% and negative of 94.7% and likelihood ratio of 433 and negative of 33,3. The area under the ROC curve was 0,78 (95% CI, 0.65-0.9). Conclusion: The present study evidenced the applicability of the MIS test and its efficacy in the diagnosis of cognitive alterations in elderly patients, with significant values of sensitivity and specificity; Presented advantages of speed, easy applicability and interpretation; Independent of culture, language and schooling. MIS offers important advantages as a screening test for use in primary health care, and further studies are needed to indicate the use of this test alone to exclude dementia.
Objective: To evaluate the performance of the Memory Impairment Screen (MIS) for the diagnostic screening of Dementia in Alzheimer's Disease (AD). Methods: Accuracy study performed at the Geriatrics Outpatient Clinic of the School Health Center of Botucatu Medical School - Unesp. A total of 126 elderly patients were enrolled, and the MIS cognitive evaluation test was applied, using the AD diagnostic criteria proposed by Frota as the gold standard. The diagnostic value was analyzed by the calculation of sensitivity, specificity, predictive values (positive and negative) and positive and negative likelihood ratio. The ROC curve was drawn to contribute to the evaluation of MIS performance in the diagnosis of AD. Results: A total of 126 elderly individuals with a mean age of 71.6 ± 7.8 years, most of them female (65.9%) and 1 to 4 years of education (40%) were evaluated. The presence of the diagnosis of Alzheimer's disease was observed in 18 (14.3%) of the elderly evaluated. The MIS cognitive screening test showed a sensitivity of 72.2%, specificity of 83.3%, positive predictive value of 41.9% and negative of 94.7% and likelihood ratio of 433 and negative of 33,3. The area under the ROC curve was 0,78 (95% CI, 0.65-0.9). Conclusion: The present study evidenced the applicability of the MIS test and its efficacy in the diagnosis of cognitive alterations in elderly patients, with significant values of sensitivity and specificity; Presented advantages of speed, easy applicability and interpretation; Independent of culture, language and schooling. MIS offers important advantages as a screening test for use in primary health care, and further studies are needed to indicate the use of this test alone to exclude dementia.
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Palavras-chave
Idosos, Demência, Doença de Alzheimer, Testes de rastreio, Memory Impairment Screen, Elderly, Dementia, Alzheimer Disease, Screening Test