中国临床心理学杂志

老年人认知功能减退知情者问卷判断阿尔茨海默病患者严重程度的效度

单位：1. 靖江市人民医院靖江 214500
2. 复旦大学附属华山医院上海 200040

分类号：R395.1

出版年,卷(期):页码：2014,22(6):1050-1052

摘要：

目的：评价老年人认知功能减退知情者问卷（IQCODE）区分阿尔茨海默病（AD）患者认知功能损害程度的有效性。方法：收集来院就诊的AD患者332例，按临床痴呆程度标准分为轻、中、重度组，应用简短版本的老年人认知功能减退知情者问卷（IQCODE）对其知情者进行问卷调查。分析各组 IQCODE 得分与简明精神状态量表（MMSE）、Mattis痴呆评定量表（DRS）、阿尔茨海默病评估量表-认知部分（ADAS-Cog）得分的相关性，检验其区分不同认知功能损害程度的效度。结果：IQCODE与MMSE、DRS、ADAS-cog的相关系数分别为-0.512、-0.478和0.522。以65分作为划界分区分轻-中度痴呆，敏感性为66.9%，特异性为57.3%；以75分作为划界分区分中-重度痴呆，敏感性为73.8%，特异性为66.9%。结论：IQCODE可以中等有效地区分不同程度的认知功能障碍，但单独使用准确性欠佳，建议临床结合其他痴呆量表使用，以提高评定效能。

Objective: To evaluate the efficacy of informant questionnaire on cognitive decline in the elderly(IQCODE) in the assessing the severity of cognitive impairment in patients with Alzheimer's disease. Methods: According to the clinical dementia rating, 332 patients with AD were classified into three groups: early, moderate and late stage group. Informants were interviewed with the short version of the IQCODE, which was used to analyse the correlation relationship with the mini-mental state examination(MMSE), the Mattis dementia rating scale(DRS) and the Alzheimer's disease assessment scale-cognitive subscale(ADAS-cog). A series of statistical analysis were carried out to measure the differences of IQCODE scores among three groups. Results: The validity coefficient of IQCODE with MMSE, DRS and ADAS-cog were-0.512, - 0.478 and 0.522 respectively. Taking an IQCODE threshold of 65 to discriminate early stage from moderate, the sensitivity was 66.9% and specificity was 57.3% while taking 75 for threshold to discriminate moderate from late, the sensitivity was 73.8% and specificity was 66.9%. Conclusion: IQCODE is moderately effective for assessing severity of cognitive impairment in patients with Alzheimer's disease, but the IQCODE alone would result in misjudgments, and combing with other clinical dementia rating scals is helpful to improve the evaluation efficiency.

基金项目：

作者简介：

参考文献：

1 Yan R, Vassar R. Targeting the β secretase BACE1 for Alzheimer’s disease therapy. The Lancet Neurology, 2014, 13 (3): 319-329
2 Limpawattana P, Tiamkao S, Sawanyawisuth K, et al. Can Rowland Universal Dementia Assessment Scale(RUDAS) replace Mini-mental State Examination(MMSE) for dementia screening in a Thai geriatric outpatient setting? American Journal of Alzheimer’s Disease and Other Dementias, 2012, 27(4): 254-259
3 Rowland JT, Basic D, Storey JE, et al. The Rowland Universal Dementia Assessment Scale(RUDAS) and the Folstein MMSE in a multicultural cohort of elderly persons. International Psychogeriatrics, 2006, 18(1): 111-120
4 Turner TH, Hinson V. Mattis dementia rating scale gutoffs are inadequate for detecting dementia in Parkinson’s disease. Applied neuropsychology. Adult, 2013, 20(1): 61-65
5 Leuchter AF, Uijtdehaage SHJ, Cook IA, et al. Relationship between brain electrical activity and cortical perfusion in normal subjects. Psychiatry Research, 1999, 90(2): 125-140
6 Senanarong V, Assavisaraporn S, Sivasiriyanonds N, et al. The IQCODE: An alternative screening test for dementia for low educated Thai elderly. Journal of the Medical Association of Thailand, 2001, 84(5): 648-655
7 Sanchez MAS, Louren?o RA. Screening for dementia: Brazilian version of the Informant Questionnaire on Cognitive Decline on the Elderly and its psychometric properties. Geriatrics and Gerontology International, 2013, 13(3): 687-693
8 Jorm AF. A short form of the informant questionnaireon cognitive decline in the elderly(IQCODE): Development and cross-validation. Psychol Med, 1994, 24: 145-153
9 Jorm AF. The Informant Questionnaire on cognitive decline in the elderly(IQCODE): a review. International Psychogeriatrics, 2004,16(3): 275-293
10 Louren?o RA, dos Santos Sanchez MA. Accuracy of the brazilian version of the informant questionnaire on cognitive decline in the elderly at screening for dementia in communitydwelling elderly participants findings from FIBRA-RJ study. Journal of Geriatric Psychiatry and Neurology, 2014, 27 (3): 212-219
11 Quinn TJ, Fearon P, Noel-Storr AH, et al. Informant Questionnaire on Cognitive Decline in the Elderly(IQCODE) for the diagnosis of dementia within community dwelling populations. Cochrane Database of Systematic Reviews, 2014 (4). Art. No.: CD010079. DOI: 10.1002/14651858.CD010079. pub2.
12 McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s Dement, 2011, 7(3): 263-269
13 World Health Organization(WHO). The neurological adaptation of the international Classification of Disease(ICD10NA). Geneva: World Health Organization, 1991
14 张振馨，洪霞. 北京城乡55岁或以上居民简易智能状态检查测试结果的分布特征. 中华神经科杂志，1999，32(3): 149-153
15 Chan AS, Choi MK, Salmon DP. The effects of age, education, and gender on the Mattis Dementia Rating Scale performance of elderly Chinese and American individuals. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 2001, 56(6): 356-363
16 Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. The American Journal of Psychiatry, 1984, 141(11): 1356-1364
17 王姮，张新卿，汤哲，等. 老年人认知功能减退知情者问卷检测老年人认知功能损害. 中华老年医学杂志，2006，25 (6): 386-388

服务与反馈：

【文章下载】【加入收藏】