社區高齡者認知篩檢工具比較：CogMate™與MoCA之相關性與篩檢效能

Performance Comparison of Cognitive Screening Tools in Community-Dwelling Older Adults: The Correlation and Screening Performances of CogMate™and MoCA

背景：失智症人口隨高齡化快速增加，社區大眾的早期辨識仍不足。蒙特利爾認知評估量表（Montreal Cognitive Assessment，MoCA）雖具良好信效度，但於社區大量篩檢受限於施測時間與人力需求，極需要更具可近性之工具。
目的：探討遊戲式智能認知測驗CogMate™應用於社區高齡者之可行性，並比較其與MoCA之相關性與辨識效度。
方法：採橫斷性研究設計，方便取樣臺中市社區65歲以上高齡者250人，施測基本人口學資料、MoCA及CogMate™。以描述性統計、Pearson相關、組內相關係數及ROC（receiver operating characteristic）曲線進行分析。
結果：研究對象中，依年齡與教育回歸校正後之MoCA分數以23分為切點，53.6%顯示疑似認知功能障礙。MoCA與CogMate™總分呈顯著正相關（r = .612，p < .001），組內相關係數為.601。CogMate™總分辨識MoCA異常之曲線下面積（area under curve）為.813，顯示具良好辨識力。
結論／實務應用：CogMate™與MoCA具良好一致性與效度，顯示其具備作為社區認知功能早期篩檢及轉介工具之潛力，可作為MoCA之輔助或替代方案。

Background: In line with the current rapid pace of population aging in Taiwan, the population of individuals living with dementia has risen significantly. However, the early identification of dementia onset in community settings remains insufficient. Although the Montreal Cognitive Assessment (MoCA) has demonstrated good reliability and validity, its applicability in large-scale community screening settings is limited by administration time and manpower requirements. Therefore, more-accessible screening tools for dementia are urgently needed.
Purpose: This study was designed to examine the feasibility of applying the game-based intelligent cognitive assessment CogMate™on older adults in community settings and to evaluate the correlation and comparative discriminative validity of this tool with the MoCA.
Methods: A cross-sectional study design with convenience sampling was employed. Two hundred and fifty community-dwelling adults aged 65 years and older in Taichung City were recruited as participants. The participants completed a demographic questionnaire, the MoCA, and CogMate™. The collected data were analyzed using descriptive statistics, Pearson correlation coefficients, intraclass correlation coefficients, and receiver operating characteristic (ROC) curve analysis.
Results: After adjusting for age and educational level, based on a cutoff score of 23, 53.6% of the participants were classified as having suspected cognitive impairment based on MoCA total score. The MoCA total score was found to correlate significantly and positively with the CogMate™total score (r = .612, p < .001), with an intraclass correlation coefficient of .601. The CogMate™total score demonstrated good discriminative performance for detecting abnormal MoCA results, with an area under the receiver operating characteristic curve (AUC) of .813.
Conclusions/ Implications for Practice: CogMate™demonstrated levels of consistency and validity similar to the MoCA, supporting its potential use as an early cognitive screening and referral tool in community settings. CogMate™may serve as a complementary or alternative tool to the MoCA in community-based cognitive assessment.