衰老中计算机化认知测试的现状：一项系统综述。
Status of computerized cognitive testing in aging: a systematic review.
作者信息
Wild Katherine, Howieson Diane, Webbe Frank, Seelye Adriana, Kaye Jeffrey
机构信息
Layton Aging and Alzheimer Center, Oregon Health and Science University, Portland, OR, USA.
出版信息
Alzheimers Dement. 2008 Nov;4(6):428-37. doi: 10.1016/j.jalz.2008.07.003.
BACKGROUND
Early detection of cognitive decline in the elderly has become of heightened importance in parallel with the recent advances in therapeutics. Computerized assessment might be uniquely suited to early detection of changes in cognition in the elderly. We present here a systematic review of the status of computer-based cognitive testing, focusing on detection of cognitive decline in the aging population.
METHODS
All studies purporting to assess or detect age-related changes in cognition or early dementia/mild cognitive impairment by means of computerized testing were included. Each test battery was rated on availability of normative data, level of evidence for test validity and reliability, comprehensiveness, and usability. All published studies relevant to a particular computerized test were read by a minimum of two reviewers, who completed rating forms containing the above mentioned criteria.
RESULTS
Of the 18 test batteries identified from the initial search, 11 were appropriate to cognitive testing in the elderly and were subjected to systematic review. Of those 11, five were either developed specifically for application with the elderly or have been used extensively with that population. Even within the computerized testing genre, great variability existed in manner of administration, ranging from fully examiner-administered to fully self-administered. All tests had at least minimal reliability and validity data, commonly reported in peer-reviewed articles. However, level of rigor of validity testing varied widely.
CONCLUSION
All test batteries exhibited some of the strengths of computerized cognitive testing: standardization of administration and stimulus presentation, accurate measures of response latencies, automated comparison in real time with an individual's prior performance as well as with age-related norms, and efficiencies of staffing and cost. Some, such as the Mild Cognitive Impairment Screen, adapted complicated scoring algorithms to enhance the information gathered from already existing tests. Others, such as CogState, used unique interfaces and subtests. We found that although basic indices of psychometric properties were typically addressed, sufficient variability exists that currently available computerized test batteries must be judged on a case-by-case basis.
背景
随着近期治疗方法的进展，老年人认知功能衰退的早期检测变得愈发重要。计算机化评估可能特别适合于老年人认知变化的早期检测。我们在此对基于计算机的认知测试状况进行系统综述，重点关注老年人群认知衰退的检测。
方法
纳入所有旨在通过计算机化测试评估或检测与年龄相关的认知变化或早期痴呆/轻度认知障碍的研究。每个测试组合根据常模数据的可用性、测试有效性和可靠性的证据水平、全面性和可用性进行评分。与特定计算机化测试相关的所有已发表研究至少由两名评审员阅读，他们完成包含上述标准的评分表。
结果
从最初搜索中确定的18个测试组合中，11个适用于老年人的认知测试，并进行了系统综述。在这11个中，有5个是专门为老年人应用而开发的，或者在该人群中广泛使用。即使在计算机化测试类型中，管理方式也存在很大差异，从完全由考官管理到完全自我管理。所有测试都至少有最低限度的可靠性和有效性数据，通常在同行评审文章中报告。然而，有效性测试的严格程度差异很大。
结论
所有测试组合都展现出计算机化认知测试的一些优势：管理和刺激呈现的标准化、反应潜伏期的准确测量、与个体先前表现以及与年龄相关规范的实时自动比较，以及人员配备和成本效率。一些测试，如轻度认知障碍筛查，采用复杂的评分算法来增强从现有测试中收集的信息。其他测试，如CogState，使用独特的界面和子测试。我们发现，尽管心理测量学特性的基本指标通常得到解决，但存在足够的变异性，目前可用的计算机化测试组合必须逐案判断。
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