Rabuñal R, Monte R, Casariego E, Pita S, Pertega S, Bal M
Servicio de Medicina Interna, Hospital Lucus Augusti, SERGAS, Lugo, España.
Rev Calid Asist. 2012 Jan-Feb;27(1):44-9. doi: 10.1016/j.cali.2011.03.007. Epub 2011 May 14.
To analyse the concordance between different scales used to assess basic activities of daily living and cognitive impairment in centenarians.
A domiciliary interview was carried out with all centenarians in our area. Three scales of basic activities of daily living (Katz index [KI], Barthel index [BI], Red Cross physical impairment index [RCPI]), and two of cognitive impairment assessment(Mini cognoscitive test [MCT], Red Cross psychic impairment index [RCPI]) were completed.
A total of 80 centenarians were interviewed, 26 men and 64 women, mean age 100.8±1.3. More than half of centenarians had functional independence or slight dependence. Men were more frequently independent than women (BI 70±34.4 vs. 50.4±36.3; P=.005). The results of cognitive impairment tests were discordant, although men had less cognitive impairment than women (MCT 16.5±9.1 vs. 11.6±8.1; P=.008). The three scales of basic activities of daily living uniformly classified the centenarians, with a high level of concordance between them: KI and BI similarly classified up to 95% of the centenarians (Kappa 0.899), BI and RCPI to 97.5% (kappa 0.95), KI and RCPI to 97.5% (Kappa 0.95). Nevertheless, the concordance between the cognitive impairment measured by RCPI and MCT was low; only 58.8% of centenarians were equally classified (Kappa 0.295).
Any of three scales analysed for assessment of basic activities of daily living is useful in centenarians. Nevertheless, the best way to assess cognitive impairment in these patients needs to be defined.
分析用于评估百岁老人日常生活基本活动能力和认知障碍的不同量表之间的一致性。
对我们地区所有百岁老人进行了一次上门访谈。完成了三个日常生活基本活动量表（卡茨指数[KI]、巴氏指数[BI]、红十字会身体损伤指数[RCPI]）以及两个认知障碍评估量表（简易认知测试[MCT]、红十字会精神损伤指数[RCPI]）。
共访谈了80位百岁老人，其中男性26位，女性64位，平均年龄100.8±1.3岁。超过一半的百岁老人具有功能独立性或轻度依赖。男性比女性更常具有独立性（BI 70±34.4对50.4±36.3；P = 0.005）。认知障碍测试结果不一致，尽管男性的认知障碍比女性少（MCT 16.5±9.1对11.6±8.1；P = 0.008）。三个日常生活基本活动量表对百岁老人的分类一致，它们之间具有高度一致性：KI和BI对高达95%的百岁老人分类相似（卡帕值0.899），BI和RCPI为97.5%（卡帕值0.95），KI和RCPI为97.5%（卡帕值0.95）。然而，RCPI和MCT所测量的认知障碍之间的一致性较低；只有58.8%的百岁老人被同等分类（卡帕值0.295）。
所分析的用于评估日常生活基本活动的三个量表中的任何一个对百岁老人都有用。然而，需要确定评估这些患者认知障碍的最佳方法。
