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ObjectiveThis study aims to discuss the current situation of mild cognitive impairment(hereinafter referred as MCI) of the rural elderly in Tai’an City, determine its prevalenceand incidence and influencing factors, provide reference for the observation and clinicaltreatment of patients. Meanwhile, it analyzes the effect of Montreal Cognitive Assessment(MoCA for short) in screening MCI of the rural elderly of the City, assesses its reliability,validity, sensitivity and specificity to MCI, and explores the best cut-off value to assist indetecting and intervening MCI of the elderly patients as early as possible.MethodsFirstly, the rural elderl’y in Taian have been screened for MCI by MMSE and MoCAby using the method of random stratified cluster sampling to calculate the prevalence rateand detectable rate of MCI of the surveyors; Five entries of Life Satisfaction Scales such asgeneral condition questionnaire of physical and mental health of the elderly, GeiratricDepression Scale (GDS), Self-rating Anxiety Scale (SAS), Social Support Revalued Scale(SSRS) have been investigated to analyze the influencing factors of MCI. Secondly,discussing MoCA by calculating its reliability, validity, sensitivity, specificity and Youdenindex to evaluate the application value of MoCA to screen MCI of the rural elderly inTai’an City, and calculating the cut-off score that suitable to the MCI patients of the ruralelderly in the city.Results1.2150people participated in this community survey, among which1971peopleshowed their complete and effective questionnaires, with the eiffciency of91.67%.615people may have depressive mood,267people may have anxious emotion,675aresuffering from high blood pressure,222high cholesterol,365coronary heart diseases,108cerebral thrombosis,273have a history of insomnia,315smoking, and648drinking.2.Among them,651are preliminary clinical diagnosed as MCI, with the overall detectable rate of33.03%, the prevalence rate of17.78%.135are diagnosed clinically asdementia, with the overall detectable rate of6.85%, the prevalence rate of3.56%.3.Factors as age, education level, occupation, different living conditions,self-consideration of physical conditions, memory, hearing, weight (abnormal BMI), bloodlipid, cerebral thrombosis, drinking, doing housework, sleep, depression, social supportstatus have a significant effect on MCI.4.Age, marital status (divorce), self-consideration of physical conditions (poor),participating activities (lack), hyperlipidemia, depression are considered as risk factors ofMCI; doing housework frequently is a protective factor5’.Cronbachs a in the MoCA is0.777, showing good reliability; comparing withMMSE, the correlation coefficient of the total score is0.737, showing good criteironvalidity; all correlation coeiffcients are significantly associated with the total score ofMoCA, showing good content validity, except line connection, copying the cube, animalnaming, digital computation.6.26is taken as the sector of MoCA recommended in the oirginal, sensitivity andspecificity of the MCI screening are98.85%and14.72%, and Youden index is0.1358.Conclusion1. As th’e rural population in Taian City being mainly farmers, the average years ofeducation being low, and the elderly occupying a major share, there are more patientssuffering from underlying diseases, prevalence of depression and anxiety is higher than theworld level, therefore, their physical and mental health conditions are not optimistic.2.As prevalence rate of MCI of the rural elderly in Tai’an is high, it is necessary tostrengthen public awareness and education and screening of MCI3.Age, marital status (divorce), imposing oneself as poor physical situation, lackingactivities, hyperlipidemia, depression are irsk factors, whereas doing housework frequentlyis a protective factor4.Though it is easy and feasible to screen the cognitive ability of the rural elderly byMoCA, and has good reliability and validity, and higher sensitivity,26as the dividing lineis low in its diagnostic value, therefore,15scores is recommended as the MCI cut-offvalue of the rural elderly in the city.5.As there are certain differences between part of subjects of MoCA and the ruralculture in the city, appropriate changes should be made in cognitive ability screening of therural elderly.
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