Abstract:

Objective To identify the sensitivity and specificity of Animal-City Alternating Form Fluency Test (ACFT) differentiating mild cognitive impairment (MCI) and Alzheimer's disease (AD) from normal controls.  Methods  A total of 121 MCI patients, 104 AD patients and 104 healthy controls, who were matched in sex, age and education level, were enrolled in this study. They performed Animal Category Verbal Fluency Test (AFT), City Category Verbal Fluency Test (CFT) and ACFT. A series of standard neuropsychological tests were also administered to reflect episodic memory, verbal ability, working memory, executive function and processing speed. The validity and related influencing factors of ACFT was evaluated.  Results  Compared with control group, the ACFT correct number in MCI and AD groups reduced significantly (P = 0.000, 0.000). Receiver operating characteristic (ROC) curve revealed the sensitivity and specificity of ACFT in discriminating MCI (P = 0.012, 0.030) and AD (P = 0.004, 0.003) from normal controls were higher than those of AFT and CFT. There was no correlation of correct number in ACFT with age and education (P > 0.05, for all). The correlations of ACFT with Stroop Color-Word Test (SCWT), Digital Symbol Substitution Test (DSST), Shape Trail Test (STT) and Digit Span Test (DS), all of which reflected attention and executive function, were significantly closer than those of AFT and CFT (P < 0.05, for all). Conclusions ACFT is more efficient in early cognitive impairment identification than the other traditional category verbal fluency tests. It is a new variant form of category verbal fluency test that could assess cognitive function and could be broadly applied in clinical practice.

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摘要：

目的 验证交替流畅性测验（ACFT）识别轻度认知损害与轻度阿尔茨海默病的敏感性和特异性。方法 共121 例轻度认知损害患者、104 例阿尔茨海默病患者和104 例性别、年龄和受教育程度相匹配的正常对照者分别接受动物范畴词语流畅性测验（AFT）、城市范畴词语流畅性测验（CFT）和ACFT 测验，并同时完成一系列经典神经心理学测验，以评价ACFT 测验诊断效度及其相关影响因素。结果 与正常对照者相比，轻度认知损害和阿尔茨海默病患者ACFT 测验正确个数均减少（P = 0.000，0.000）。受试者工作特征曲线显示，ACFT 测验识别正常对照者与轻度认知损害患者（P = 0.012，0.030）和轻度阿尔茨海默病患者（P = 0.004，0.003）的敏感性和特异性均优于AFT 和CFT 测验。ACFT 测验正确个数与受试者年龄和受教育程度无关联性（均P > 0.05）；而与反映注意力和执行功能的Stroop 色词测验、数字符号转换测验、连线测验、数字广度测验的关联性优于AFT 和CFT 测验（均P < 0.05）。结论 ACFT 测验较传统词语流畅性测验对识别认知功能障碍具有较好的效度，值得临床推广应用。

关键词: 阿尔茨海默病, 认知障碍, 神经心理学测验