摘要
背景:日常生活活动能力(ADL)受损是阿尔茨海默病(AD)痴呆的一个特点,但是轻度认知功能障碍(MCI)也报道了工具性日常生活活动能力受损(IADL)。结构式访谈和评分工具-马萨诸塞老年痴呆研究中心(MADRC)-被调查者报告 (两者简称SIST-M-IR)包括60种帮助评定临床痴呆等级得分的条目;它评定的痴呆范围和ADL变化与早期AD有关。60种SIST-M-IR 条目中,有41种是针对IADL;我们旨在确定最好的区分MCI患者与临床上正常(CN)老人的方法。方法:我们对参与MADRC 纵向队列的447样本进行了评估(289 CN, 158 MCI)。我们利用logistic 回归分析法预测SIST-M-IR 条目识别CN和 MCI的概率。根据人口特征调整分析方法。结果:我们发现4种SIST-M-IR 条目更好的区分CN和MCI受试者(MCI患者执行力较CN差):参与检索词的游戏(p=0.0001)、浏览不熟悉的区域(p=0.001)、执行涉及先前主要工作的思维任务(p=0.002) 及解决问题或完成项目(p=0.002)。结论:我们的实验结果表明老年人早期的功能性变化发现有患AD的风险,它可能被一些简单的问题引起。掌握临床评价工具的灵敏度可以帮助临床医生区分正常老化与那些正在向认知损害发展的患者。
关键词: 日常生活活动能力,阿尔茨海默病,临床评估,临床上正常老人,日常功能,轻度认知功能障碍
Current Alzheimer Research
Title:SIST-M-IR Activities of Daily Living Items that Best Discriminate Clinically Normal Elderly from those with Mild Cognitive Impairment
Volume: 11 Issue: 8
Author(s): Amy S. Zoller, Ildiko M. Gaal, Christine A. Royer, Joseph J. Locascio, Rebecca E. Amariglio, Deborah Blacker, Olivia I. Okereke, Keith A. Johnson, Reisa A. Sperling, Dorene M. Rentz and Gad A. Marshall
Affiliation:
关键词: 日常生活活动能力,阿尔茨海默病,临床评估,临床上正常老人,日常功能,轻度认知功能障碍
摘要: Background: Activities of daily living (ADL) impairment is a hallmark of Alzheimer’s disease (AD) dementia, but impairment in instrumental ADL (IADL) has been reported in mild cognitive impairment (MCI). The Structured Interview and Scoring Tool-Massachusetts Alzheimer’s Disease Research Center (MADRC)-Informant Report (SIST-MIR) includes 60 graded items that assist in scoring the Clinical Dementia Rating; it assesses the spectrum of cognitive and ADL changes relevant to early AD. Of the 60 SIST-M-IR items, 41 address IADL; we aimed to determine which of these best discriminate individuals with MCI from clinically normal (CN) elderly. Methods: We assessed 447 subjects participating in the MADRC longitudinal cohort (289 CN, 158 MCI). We performed logistic regression analyses predicting the probability of CN vs. MCI diagnosis using the SIST-M-IR items. Analyses were adjusted for demographic characteristics. Results: We found that 4 SIST-M-IR items best discriminated between CN and MCI subjects (MCI performing worse than CN): “participating in games that involve retrieving words” (p=0.0001), “navigating to unfamiliar areas” (p=0.001), “performing mental tasks involved in a former primary job” (p=0.002), and “fixing things or finishing projects” (p=0.002). Conclusions: Our results point to the earliest functional changes seen in elderly at risk for AD, which could be captured by a few simple questions. Honing the sensitivity of clinical assessment tools will help clinicians differentiate those individuals with normal aging from those who are developing cognitive impairment.
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Amy S. Zoller, Ildiko M. Gaal, Christine A. Royer, Joseph J. Locascio, Rebecca E. Amariglio , Deborah Blacker, Olivia I. Okereke, Keith A. Johnson, Reisa A. Sperling, Dorene M. Rentz and Marshall A. Gad, SIST-M-IR Activities of Daily Living Items that Best Discriminate Clinically Normal Elderly from those with Mild Cognitive Impairment, Current Alzheimer Research 2014; 11 (8) . https://dx.doi.org/10.2174/156720501108140910122220
DOI https://dx.doi.org/10.2174/156720501108140910122220 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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