Zec R F, Landreth E S, Vicari S K, Belman J, Feldman E, Andrise A, Robbs R, Becker R, Kumar V
Department of Psychiatry, Southern Illinois University School of Medicine, Springfield 62794-9230.
Alzheimer Dis Assoc Disord. 1992 Fall;6(3):164-81. doi: 10.1097/00002093-199206030-00004.
The Alzheimer Disease Assessment Scale (ADAS) was administered to 61 Alzheimer patients, 52 elderly controls, and 80 controls between age 7 and 54 years. The Alzheimer group was categorized into different severity levels of dementia based on MMSE scores: very mild (> or = 24), mild (> or = 20), moderate (10-19), and severe (0-9). All 11 ADAS Cognitive subtest scores for the mild, moderate, and severe dementia groups were statistically worse than the elderly control group. This was also the case for the very mild group, except for Naming, Commands, Constructional Praxis, and Ideational Praxis. In terms of magnitude of effect, memory and spontaneous language items were the earliest indicators on the ADAS, while praxis, commands, and naming items were only sensitive later in the course of the disorder. The best single indicators of progression throughout the severity continuum of dementia (i.e., from normal to severe) were the Orientation subtest, the ADAS Cognitive score, and the ADAS Total score. The ADAS Noncognitive subtests generally did not show the progression with increasing dementia that was evident on the ADAS Cognitive subtest. Differences in educational level had no statistically significant effects on any of the ADAS subtest scores, and age differences were few and small in magnitude. The differential rate of decline of the various ADAS subtests appears to reflect both the changing pattern of cognitive impairments as a function of severity of DAT and also to some extent the psychometric limitations of some of the subtests.
对61名阿尔茨海默病患者、52名老年对照者以及80名年龄在7至54岁之间的对照者进行了阿尔茨海默病评估量表（ADAS）测试。根据简易精神状态检查表（MMSE）得分，将阿尔茨海默病组分为不同严重程度的痴呆：极轻度（≥24分）、轻度（≥20分）、中度（10 - 19分）和重度（0 - 9分）。轻度、中度和重度痴呆组的所有11项ADAS认知子测试得分在统计学上均比老年对照组差。极轻度组也是如此，但命名、指令、结构性运用和观念性运用这几项除外。就效应大小而言，记忆和自发语言项目是ADAS上最早出现变化的指标，而运用、指令和命名项目在疾病过程后期才变得敏感。在痴呆严重程度连续体（即从正常到重度）中，进展的最佳单一指标是定向力子测试、ADAS认知得分和ADAS总分。ADAS非认知子测试一般未显示出随着痴呆加重而出现像ADAS认知子测试那样明显的进展情况。教育水平差异对任何ADAS子测试得分均无统计学上的显著影响，年龄差异数量少且幅度小。ADAS各子测试不同的下降速率似乎既反映了作为阿尔茨海默病痴呆严重程度函数的认知障碍变化模式，也在一定程度上反映了某些子测试的心理测量局限性。
