Nathan S. Kline Institute for Psychiatric Research, 1 Wards Island Complex, Wards Island New York, NY 10035, USA.
Curr Alzheimer Res. 2013 Nov;10(9):952-63. doi: 10.2174/15672050113106660160.
Considering the scarcity of longitudinal assessments of reliability, there is need for a more precise understanding of cognitive decline in Alzheimer's Disease (AD). The primary goal was to assess longitudinal changes in inter-rater reliability, test retest reliability and internal consistency of scores of the ADAS-Cog.
2,618 AD subjects were enrolled in seven randomized, double-blind, placebo-controlled, multicenter-trials from 1986 to 2009. Reliability, internal-consistency and cross-sectional analysis of ADAS-Cog and MMSE across seven visits were examined.
Intra-class correlation (ICC) for ADAS-Cog was moderate to high supporting their reliability. Absolute Agreement ICCs 0.392 (Visit-7) to 0.806 (Visit-2) showed a progressive decrease in correlations across time. Item analysis revealed a decrease in item correlations, with the lowest correlations for Visit 7 for Commands (ICC=0.148), Comprehension (ICC=0.092), Spoken Language (ICC=0.044).
Suitable assessment of AD treatments is maintained through accurate measurement of clinically significant outcomes. Targeted rater education ADAS-Cog items over-time can improve ability to administer and score the scale.
考虑到可靠性的纵向评估稀缺，需要更精确地了解阿尔茨海默病（AD）的认知下降。主要目标是评估 ADAS-Cog 的评分的组内可靠性、重测信度和内部一致性的纵向变化。
1986 年至 2009 年，2618 名 AD 患者参加了七项随机、双盲、安慰剂对照、多中心试验。检查了 ADAS-Cog 和 MMSE 在七次就诊中的可靠性、内部一致性和横断面分析。
ADAS-Cog 的组内相关系数（ICC）为中等到高度，支持其可靠性。绝对一致性 ICC 为 0.392（就诊 7）至 0.806（就诊 2），表明随着时间的推移相关性逐渐降低。项目分析显示项目相关性下降，对于就诊 7 的命令（ICC=0.148）、理解（ICC=0.092）、口语（ICC=0.044）的相关性最低。
通过准确测量临床显著结局，维持了对 AD 治疗的适当评估。针对 ADAS-Cog 项目的评分，随着时间的推移，评分者的教育可以提高管理和评分的能力。
