Abstract：
OBJECTIVE: The prevalence of mixed dementia (MixD), defined as the coexistence of Alzheimer\'s disease (AD) and vascular dementia (VaD), is likely to increase as the population ages. The five-word test (5WT) is a neuropsychological test that differentiates between major and mild neurocognitive disorder (NCD). The objective of the study is to validate 5WT for the detection of MixD.
METHODS: 230 participants were evaluated: cognitively healthy (CH) (n=70), mild NCD (n=70), and major NCD (n=90): AD (n=30), VaD (n=30), and MixD (n=30). The Spearman\'s coefficient, d Sommer and ROC curves were used to determine the construct validity of the 5WT. The linear regression model was performed to determine the association between age and education with 5WT performance.
RESULTS: The mean age was 79 ±7.7 years (P≤.001), 58% were female (P=.252), and the mean education was 9 ±5.3 years (P≤.001). Construct validity when comparing 5WT and MMSE was: Spearman\'s correlation ρ=.830 (P<.001) and d Sommer=.41 (P<.001). The area under the curve in the total weighted score (TWS) for MixD was .985, with 98% sensitivity (95%CI, 0.96-1.00) and 99% specificity (95%CI, 0.94-1.00), PPV of 88% (95%CI, 0.82-0.89), NPV of 100% (95%CI, 0.96-1.00), and cut-off point ≤16/20 (P<.001).
CONCLUSIONS: 5WT is a rapid test with neuropsychological validation for the exploration of cognitive characteristics in major NCD type MixD, regardless of age and education.
METHODS: 230 participants were evaluated: cognitively healthy (CH) (n=70), mild NCD (n=70), and major NCD (n=90): AD (n=30), VaD (n=30), and MixD (n=30). The Spearman\'s coefficient, d Sommer and ROC curves were used to determine the construct validity of the 5WT. The linear regression model was performed to determine the association between age and education with 5WT performance.
RESULTS: The mean age was 79 ±7.7 years (P≤.001), 58% were female (P=.252), and the mean education was 9 ±5.3 years (P≤.001). Construct validity when comparing 5WT and MMSE was: Spearman\'s correlation ρ=.830 (P<.001) and d Sommer=.41 (P<.001). The area under the curve in the total weighted score (TWS) for MixD was .985, with 98% sensitivity (95%CI, 0.96-1.00) and 99% specificity (95%CI, 0.94-1.00), PPV of 88% (95%CI, 0.82-0.89), NPV of 100% (95%CI, 0.96-1.00), and cut-off point ≤16/20 (P<.001).
CONCLUSIONS: 5WT is a rapid test with neuropsychological validation for the exploration of cognitive characteristics in major NCD type MixD, regardless of age and education.
摘要：
目标：混合性痴呆（MixD）的患病率，定义为阿尔茨海默病(AD)和血管性痴呆(VaD)共存，可能会随着人口老龄化而增加。五字测验（5WT）是一种神经心理学测验，可区分重度和轻度神经认知障碍（NCD）。该研究的目的是验证用于检测MixD的5WT。
方法：对230名参与者进行了评估：认知健康（CH）（n=70），轻度NCD（n=70），主要非传染性疾病（n=90）：AD（n=30），VaD（n=30），和MixD(n=30)。斯皮尔曼系数,dSommer和ROC曲线用于确定5WT的构建有效性。进行线性回归模型以确定年龄和受教育程度与5WT表现之间的关联。
结果：平均年龄为79±7.7岁（P≤0.001），58%为女性(P=.252)，平均受教育时间为9±5.3年（P≤0.001）。比较5WT和MMSE时的结构效度为：斯皮尔曼相关性ρ=.830（P<.001），dSommer=.41（P<.001）。MixD的总加权评分（TWS）曲线下面积为.985，敏感性为98％（95CI，0.96-1.00），特异性为99％（95CI，0.94-1.00），PPV为88%（95CI，0.82-0.89），净现值为100%（95CI，0.96-1.00），截止点≤16/20(P<.001)。
结论：5WT是一种具有神经心理学验证的快速测试，用于探索主要NCD类型MixD的认知特征，无论年龄和教育。
方法：对230名参与者进行了评估：认知健康（CH）（n=70），轻度NCD（n=70），主要非传染性疾病（n=90）：AD（n=30），VaD（n=30），和MixD(n=30)。斯皮尔曼系数,dSommer和ROC曲线用于确定5WT的构建有效性。进行线性回归模型以确定年龄和受教育程度与5WT表现之间的关联。
结果：平均年龄为79±7.7岁（P≤0.001），58%为女性(P=.252)，平均受教育时间为9±5.3年（P≤0.001）。比较5WT和MMSE时的结构效度为：斯皮尔曼相关性ρ=.830（P<.001），dSommer=.41（P<.001）。MixD的总加权评分（TWS）曲线下面积为.985，敏感性为98％（95CI，0.96-1.00），特异性为99％（95CI，0.94-1.00），PPV为88%（95CI，0.82-0.89），净现值为100%（95CI，0.96-1.00），截止点≤16/20(P<.001)。
结论：5WT是一种具有神经心理学验证的快速测试，用于探索主要NCD类型MixD的认知特征，无论年龄和教育。
