认知障碍对青光眼视野检查可靠性的影响及Mini-Cog评分预警模型的建立OA

Objective:To examine the impact of cognitive impairment on the reliability of visual field assessments in glaucoma patients,and to establish and validate a predictive model utilizing Mini-Cog Scores for early warning.Methods:A retrospective analysis was conducted on clinical data from 306 glaucoma patients treated at our institution between January 2022 and December 2024,forming the training cohort.Patients meeting reliability criteria(fixation loss ≤20％,false positive rate ≤15％,false negative rate ≤33％)were assigned to the study group(n=209),while those failing to meet these benchmarks constituted the control group(n=97).Inter-group comparisons of clinical characteristics were performed,with Logistic regression analysis employed to identify determinants of visual field reliability.Predictive capabilities of individual factors were evaluated through ROC curve analysis.An additional validation cohort comprised 131 glaucoma patients treated from January to June 2025,selected using the same criteria.A nomogram was developed via the Storm Statistics platform,with its predictive accuracy and clinical applicability assessed through calibration curves,ROC curve analysis,and decision curve evaluation.Results:The age and disease duration of the control group were significantly higher than those of the study group,while the best corrected visual acuity and Mini-Cog Score were significantly lower than those of the study group(all P＜0.01).Multivariate Logistic regression identified age and disease duration as independent risk factors compromising visual field reliability,whereas best corrected visual acuity and Mini-Cog Scores emerged as independent protective factors(all P＜0.05).Mini-Cog Score demonstrated superior predictive value relative to age,disease duration,and best corrected visual acuity(P＜0.01).The constructed nomogram exhibited high predictive probability for visual field reliability,with AUC values of 0.89(95％CI:0.85-0.94)in the training set and 0.90(95％CI:0.82-0.98)in the validation set,indicating robust predictive performance.Calibration curves confirmed strong concordance between predicted probabilities and observed outcomes(P＞0.05).Decision curve analysis revealed substantial clinical net benefit when threshold probabilities ranged from 30％to 90％.Conclusion:Cognitive impairment substantially compromises the reliability of visual field testing in glaucoma patients.The early warning model incorporating Mini-Cog Scores demonstrates favorable predictive capability and practical clinical value.