Twamley Elizabeth W, Doshi Rishi R, Nayak Gauri V, Palmer Barton W, Golshan Shahrokh, Heaton Robert K, Patterson Thomas L, Jeste Dilip V
UCSD Department of Psychiatry, VA San Diego Healthcare System (116A-1), 3350 La Jolla Village Drive, La Jolla, CA 92161, USA.
Am J Psychiatry. 2002 Dec;159(12):2013-20. doi: 10.1176/appi.ajp.159.12.2013.
This study examined the relationship between performance of instrumental activities of daily living, as measured with the University of California, San Diego, Performance-Based Skills Assessment (UPSA), and measures of cognitive functioning and independence in the community living situation of older outpatients with psychotic disorders.
One hundred eleven middle-aged and elderly outpatients with primary psychotic disorders were administered the UPSA, the Mattis Dementia Rating Scale, and standardized measures of psychopathology. Independence in the community living situation was rated on a scale from 1 to 5, with 5 representing the highest level of independence, such as living alone in an apartment or house. Ability in seven domains of neuropsychological functioning was assessed in 67 participants.
Total scores on the University of California, San Diego, Performance-Based Skills Assessment were significantly correlated with total and subscale scores on the Mattis Dementia Rating Scale, level of independence in the community living situation, and scores on the neuropsychological measures in the subset of patients who underwent neuropsychological testing. Lower scores on the Mattis Dementia Rating Scale memory subscale and more severe negative symptoms were significantly associated with worse performance on the skills assessment. Performance on the skills assessment contributed uniquely to prediction of independence in the community living situation.
Generalized cognitive abilities are associated with everyday functioning capacity in older patients with psychosis. Reduction of cognitive deficits and negative symptoms may improve patients' ability to function independently in the community.
本研究探讨了用加利福尼亚大学圣地亚哥分校基于表现的技能评估（UPSA）所衡量的日常生活工具性活动表现，与老年精神病性障碍门诊患者社区生活状况下认知功能及独立性测量指标之间的关系。
对111名患有原发性精神病性障碍的中老年门诊患者进行了UPSA、马蒂斯痴呆评定量表及精神病理学标准化测量。社区生活状况的独立性按1至5分进行评分，5分代表最高独立水平，如独自居住在公寓或房屋中。对67名参与者的神经心理功能七个领域的能力进行了评估。
加利福尼亚大学圣地亚哥分校基于表现的技能评估总分，与马蒂斯痴呆评定量表的总分及分量表得分、社区生活状况的独立水平，以及接受神经心理测试的患者亚组中神经心理测量得分显著相关。马蒂斯痴呆评定量表记忆分量表得分较低及更严重的阴性症状，与技能评估中较差的表现显著相关。技能评估表现对社区生活状况独立性的预测有独特贡献。
广义认知能力与老年精神病患者的日常功能能力相关。减少认知缺陷和阴性症状可能会提高患者在社区中独立生活的能力。
