O'Connor D W
Monash University, Heatherton Hospital, Cheltenham, Victoria, Australia.
Psychiatr J Univ Ott. 1990 Nov;15(4):216-20.
Distinguishing between cognitively intact and mildly demented elderly people poses particular difficulties. Now that modern criteria, such as those contained in the DSM-III-R, specify that cognitive deficits be sufficient to interfere with the pursuit of daily tasks, investigators must consider the relative effects of personality, physical illness and handicap, sensory deficits and functional psychiatric disorders since all of these factors contribute to loss of independence. Simple tests and questionnaires are inadequate to the task and are subject to demographic bias but structured assessments conducted by skilled clinicians using operational criteria have much to offer, notwithstanding the increased costs and time required. This paper discusses some of the issues involved and presents evidence concerning the use of CAMDEX in a recent British survey.
区分认知功能正常的老年人和轻度痴呆的老年人存在特殊困难。鉴于现代标准，如《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）中所包含的标准，明确规定认知缺陷必须足以干扰日常任务的进行，研究人员必须考虑人格、身体疾病与残疾、感觉缺陷以及功能性精神障碍的相对影响，因为所有这些因素都会导致独立性丧失。简单的测试和问卷调查不足以完成这项任务，且容易受到人口统计学偏差的影响，但由熟练的临床医生使用操作标准进行的结构化评估却有很大的作用，尽管所需成本和时间有所增加。本文讨论了其中涉及的一些问题，并提供了关于在最近一项英国调查中使用剑桥老年精神状态检查表（CAMDEX）的证据。
