Lam Linda C W, Tam Cindy W C, Lui Victor W C, Chan Wai C, Chan Sandra S M, Ho Kin S, Chan Wai M, Chiu Helen F K
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR.
Alzheimer Dis Assoc Disord. 2008 Apr-Jun;22(2):153-7. doi: 10.1097/WAD.0b013e3181631517.
With increasing demand for dementia care in the Chinese community, there is a pressing need to identify practical and valid assessment tool for early detection of dementia. In a sample of 473 randomly recruited community-dwelling Chinese older persons aged 60 or above, we evaluated the cognitive characteristics of subjects with Clinical Dementia Rating (CDR) of 0.5. The cognitive profiles of CDR 0.5 subjects were compared with standard clinical criteria for mild cognitive impairment. The Alzheimer's disease assessment scale-cognitive subscale and list learning delay recall test scores were between -1 and -2 SD below the cutoff for clinically not-demented subjects (CDR 0). Concordance between CDR 0.5 and mild cognitive impairment classifications were related to educational level of the subjects. A higher agreement was found in subjects having >6 years of education than subjects having <or=2 years of education (85.2% vs. 53.8%) (chi2=35.41, df=2, P<0.0001). The results suggested that CDR is able to identify mild but significant cognitive impairment in the Chinese community. The use of CDR suggested that attention should be paid to local cultural characteristics. With the use of cognitive evaluation, special adjustments are required to fit the performance of the respondents with different educational background.
随着华人社区对痴呆症护理的需求不断增加，迫切需要确定实用且有效的评估工具以早期检测痴呆症。在一个由473名年龄在60岁及以上、随机招募的居住在社区的华人老年人组成的样本中，我们评估了临床痴呆评定量表（CDR）评分为0.5的受试者的认知特征。将CDR评分为0.5的受试者的认知概况与轻度认知障碍的标准临床标准进行了比较。阿尔茨海默病评估量表-认知子量表和列表学习延迟回忆测试分数比临床非痴呆受试者（CDR 0）的临界值低1至2个标准差。CDR 0.5与轻度认知障碍分类之间的一致性与受试者的教育水平有关。受教育年限>6年的受试者比受教育年限≤2年的受试者一致性更高（85.2%对53.8%）（χ²=35.41，自由度=2，P<0.0001）。结果表明，CDR能够识别华人社区中轻度但显著的认知障碍。CDR的使用表明应关注当地文化特征。在使用认知评估时，需要进行特殊调整以适应不同教育背景受访者的表现。
