Marrie Ruth Ann, Miller Deborah M, Chelune Gordon J, Cohen Jeffrey A
Mellen Center for Multiple Sclerosis Treatment and Research, Department of Neurology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Mult Scler. 2003 Dec;9(6):621-6. doi: 10.1191/1352458503ms971oa.
Multiple sclerosis (MS) has important effects on quality of life but it is unknown how cognitive impairment affects the ability to assess or report this. Our objective was to determine whether cognitive impairment negatively affects the construct validity and the reliability of the Multiple Sclerosis Quality of Life Inventory (MSQLI). A neuropsychological test battery and the Multiple Sclerosis Functional Composite (MSFC) were administered to a sample of 136 patients referred for cognitive testing by their neurologists. Age, sex, education and ethnicity-adjusted T scores were calculated for each cognitive variable. Cognitive impairment was defined as any T score less than the fifth percentile. The MSQLI was administered prior to neuropsychological testing and readministered one to four weeks later: Correlations between the MSFC and the SF-36 were determined and compared between the cognitively impaired and unimpaired groups as the main test of construct validity. Test-retest and internal consistency reliability of each of the scales were compared for the impaired and unimpaired groups. Seventy-six (56%) patients were cognitively impaired. Construct validity and internal consistency reliability did not differ between the cognitively impaired and unimpaired groups. Test retest reliability was lower for the bladder and vision scales in the impaired group, but remained acceptable for the bladder scale (r > 0.7). Cognitive impairment, a common MS manifestation, does not appear to reduce the reliability or validity of the MSQLI as a patient self-report measure of health status and quality of life.
多发性硬化症（MS）对生活质量有重要影响，但尚不清楚认知障碍如何影响评估或报告生活质量的能力。我们的目的是确定认知障碍是否会对多发性硬化症生活质量量表（MSQLI）的结构效度和信度产生负面影响。对136名由神经科医生转介进行认知测试的患者样本进行了一套神经心理测试和多发性硬化症功能综合测试（MSFC）。计算每个认知变量的年龄、性别、教育程度和种族调整后的T分数。认知障碍定义为任何T分数低于第五百分位数。在神经心理测试之前对MSQLI进行施测，并在1至4周后重新施测：确定MSFC与SF-36之间的相关性，并在认知受损组和未受损组之间进行比较，作为结构效度的主要测试。比较受损组和未受损组各量表的重测信度和内部一致性信度。76名（56%）患者存在认知障碍。认知受损组和未受损组在结构效度和内部一致性信度方面没有差异。受损组膀胱和视力量表的重测信度较低，但膀胱量表仍可接受（r>0.7）。认知障碍是MS的常见表现，作为患者自我报告的健康状况和生活质量指标，它似乎不会降低MSQLI的信度或效度。
