인지평가 참고진단 시스템(CARDS)의 진단능력

Diagnostic Capability of the Cognitive Assessment and Reference Diagnoses System(CARDS)

Background： Recent therapeutic advances to delay the progression of dementia have renewed calls to improve early detection and management of individuals with dementia. A new computerized neuropsychological interview and clinical examination, the Cognitive Assessment and Reference Diagnosis System (CARDS) was developed to incorporate in a single instrument all the information required to make an accurate clinical diagnosis of dementia, its subtype, depression and delirium, to present reference diagnoses just after completion of tests, and to detect early dementia. This study aims to verify the diagnostic capability of the CARDS. Methods：The CARDS was administered to 56 dementia patients (38 Alzheimer's disease, 18 vascular dementia) as well as 40 nondemented subjects. To evaluate the sensitivity and specificity of the CARDS, we compared the CARDS diagnosis with the clinician’s diagnosis on dementia, Alzheimer's disease, vascular dementia and depression. To test diagnostic capability of the CARDS in the diagnosis of early dementia, we compared mean scores of total and subscales in the CARDS of GDS stage 3 group with those of GDS stage 4 group. Results：The CARDS demonstrated high levels of sensitivity and specificity in the diagnosis of dementia, AD, VaD and depression. Mean CARDS scores for total and 3 subscales (amnesia, aphasia, agnosia) in GDS stage 3 group were significantly different from those of GDS stage 4 group (p<0.001). Conclusion：We demonstrated that CARDS is valid instrument not only for dementia diagnosis but also for detection of early dementia.