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认知功能变化评估:在 CERAD-NP 成套测验上测试的老年人群的年龄、教育和性别特异性可靠变化指数:初级保健患者中德国老龄化、认知和痴呆研究(AgeCoDe)的结果。

The assessment of changes in cognitive functioning: age-, education-, and gender-specific reliable change indices for older adults tested on the CERAD-NP battery: results of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe).

机构信息

Public Health Research Unit, University of Leipzig, Leipzig, Saxony, Germany.

出版信息

Am J Geriatr Psychiatry. 2012 Jan;20(1):84-97. doi: 10.1097/JGP.0b013e318209dd08.


DOI:10.1097/JGP.0b013e318209dd08
PMID:22183013
Abstract

OBJECTIVES: The Consortium to Establish a Registry for Alzheimer's Disease-Neuropsychological (CERAD-NP) battery represents a commonly used neuropsychological instrument to measure cognitive functioning in the elderly. This study provides normative data for changes in cognitive function that normally occur in cognitively healthy individuals to interpret changes in CERAD-NP test scores over longer time periods. DESIGN: Longitudinal cohort study with three assessments at 1.5-year intervals over a period of 3 years. SETTING: : Primary care medical record registry sample. PARTICIPANTS: As part of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients, a sample of 1,450 cognitively healthy general practitioner patients, age 75 years and older, was assessed. MEASUREMENTS: Age-, education-, and gender-specific Reliable Change Indices (RCIs) were computed for a 90% confidence interval for selected subtests of the CERAD-NP battery. RESULTS: Across different age, education, and gender subgroups, changes from at least six to nine points in Verbal Fluency, four to eight points in Word List Memory, two to four points in Word List Recall, and one to four points in Word List Recognition indicated significant (i.e. reliable) changes in CERAD-NP test scores at the 90% confidence level. Furthermore, the calculation of RCIs for individual patients is demonstrated. CONCLUSIONS: Smaller changes in CERAD-NP test scores can be interpreted with only high uncertainty because of probable measurement error, practice effects, and normal age-related cognitive decline. This study, for the first time, provides age-, education-, and gender-specific CERAD-NP reference values on the basis of RCI methods for the interpretation of cognitive changes in older-age groups.

摘要

目的:阿尔茨海默病神经心理学登记研究联盟(CERAD-NP)电池代表了一种常用的神经心理学工具,用于测量老年人的认知功能。本研究提供了认知健康个体认知功能正常变化的规范数据,以解释 CERAD-NP 测试分数在较长时间内的变化。

设计:纵向队列研究,在 3 年期间每隔 1.5 年进行 3 次评估。

地点:初级保健医疗记录登记样本。

参与者:作为德国初级保健患者老龄化、认知和痴呆研究的一部分,对 1450 名认知健康的全科医生患者进行了评估,年龄在 75 岁及以上。

测量:计算了 CERAD-NP 电池选定子测试的年龄、教育和性别特异性可靠变化指数(RCI),置信区间为 90%。

结果:在不同的年龄、教育和性别亚组中,从至少 6 分到 9 分的词语流畅性、4 分到 8 分的单词记忆、2 分到 4 分的单词回忆以及 1 分到 4 分的单词识别的变化表明 CERAD-NP 测试分数在 90%的置信水平上发生了显著(即可靠)变化。此外,还展示了为个别患者计算 RCI 的方法。

结论:由于可能存在测量误差、练习效应和正常的年龄相关认知衰退,CERAD-NP 测试分数的较小变化只能在高度不确定的情况下进行解释。本研究首次基于 RCI 方法为年龄较大的人群提供了 CERAD-NP 的年龄、教育和性别特异性参考值,用于解释认知变化。

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