Fuld P A, Masur D M, Blau A D, Crystal H, Aronson M K
Albert Einstein College of Medicine.
J Clin Exp Neuropsychol. 1990 Aug;12(4):520-8. doi: 10.1080/01688639008400998.
In a prospective study of dementia in initially normal functioning elderly, a brief form of the Fuld Object-Memory Evaluation (OM) was administered to 474 cognitively normal community-residing volunteers aged 75-85 at baseline and annually thereafter. Seventy-two subjects later became demented. Memory test data from the last annual evaluation before cognitive change was noted were available for 56. Although the entire population recalled 7.28 (SD = 1.33) of the 10 objects on Trial 1 of the test at baseline, these 56 subjects recalled only 5.96 (SD = 1.85). When recall of 6 or fewer objects was used as a predictor, the OM test identified 32 of the 56 who subsequently became demented. Compared to an estimated base rate of 15% for dementia, the predictive value of a positive test (PV+) was 39%, and that of a negative test (PV-) was 89%. With a cutoff of 5 or fewer items recalled, the PV+ rose to 59% and the PV- was 94%. Although the OM test was only moderately sensitive to incipient dementia (.57), it was fairly specific (.84), and lowering the cutoff to 5 increased the specificity to .96. Memory testing would therefore seem to hold promise as a predictor of dementia in cognitively normal elderly.
在一项针对最初功能正常的老年人痴呆症的前瞻性研究中，对474名年龄在75 - 85岁、认知正常且居住在社区的志愿者在基线时进行了简短形式的福尔兹物体记忆评估（OM），此后每年进行一次评估。后来有72名受试者患上了痴呆症。对于56名受试者，可获得认知变化出现前最后一次年度评估的记忆测试数据。尽管整个人群在测试的第1次试验中基线时能回忆起10个物体中的7.28个（标准差 = 1.33），但这56名受试者仅能回忆起5.96个（标准差 = 1.85）。当将回忆6个或更少物体作为预测指标时，OM测试在后来患上痴呆症的56名受试者中识别出了32名。与估计的痴呆症基础发病率15%相比，阳性测试的预测值（PV +）为39%，阴性测试的预测值（PV -）为89%。当回忆项目的截止值为5个或更少时，PV +升至59%，PV -为94%。尽管OM测试对早期痴呆症的敏感性仅为中等水平（0.57），但其特异性相当高（0.84），将截止值降至5可将特异性提高到0.96。因此，记忆测试似乎有望成为认知正常老年人痴呆症的预测指标。
