Department of Gerontology and Rehabilitation, St Finbarr's Hospital, Douglas Road, Cork City, Ireland.
J Clin Epidemiol. 2014 Jan;67(1):87-92. doi: 10.1016/j.jclinepi.2013.07.009. Epub 2013 Sep 25.
The Alzheimer's Disease Assessment Scale-cognitive section and its standardized version (SADAS-cog) are the current standard for assessing cognitive outcomes in clinical trials of dementia. This study compares a shorter cognitive instrument, the Quick Mild Cognitive Impairment (Qmci) screen, with the SADAS-cog as outcome measures in clinical trials.
The SADAS-cog, Qmci, Clinical Dementia Rating (CDR) scale, and the Lawton-Brady activities of daily living (ADL) scale were assessed at multiple time points, over 1 year in a multicenter randomized clinical trial of 406 patients with mild to moderate Alzheimer's dementia. Correlations were estimated using regression at each time point, all time points, and mean values across time. Responsiveness was assessed using the standardized response mean (SRM).
Regression for pooled time points showed strong and significant correlation between the SADAS-cog and Qmci (r = -0.75, P < 0.001). Correlations remained strong for mean values across time and at each time point. The SADAS-cog and Qmci also correlated with CDR and ADL scores. There was no difference in SRMs between the SADAS-cog and Qmci [t(357) = -0.32, P = 0.75].
The Qmci correlated strongly with the SADAS-cog and both were equally responsive to deterioration. We suggest that clinicians and investigators can substitute the shorter Qmci for the SADAS-cog.
阿尔茨海默病评估量表认知部分及其标准化版本(SADAS-cog)是目前评估痴呆症临床试验认知结果的标准。本研究比较了一种更短的认知工具,即快速轻度认知障碍(Qmci)筛查,与 SADAS-cog 作为临床试验的结果测量。
在一项多中心随机临床试验中,对 406 名轻度至中度阿尔茨海默病痴呆患者进行了多次评估,为期 1 年,评估了 SADAS-cog、Qmci、临床痴呆评定量表(CDR)和 Lawton-Brady 日常生活活动(ADL)量表。在每个时间点、所有时间点和时间平均值上,使用回归估计相关性。使用标准化反应均值(SRM)评估反应性。
pooled time points 的回归显示,SADAS-cog 和 Qmci 之间存在强烈且显著的相关性(r = -0.75,P < 0.001)。在时间平均值和每个时间点上,相关性仍然很强。SADAS-cog 和 Qmci 也与 CDR 和 ADL 评分相关。SADAS-cog 和 Qmci 之间的 SRM 没有差异[t(357) = -0.32,P = 0.75]。
Qmci 与 SADAS-cog 高度相关,两者对恶化的反应性相同。我们建议临床医生和研究人员可以用更短的 Qmci 代替 SADAS-cog。