Lebedeva Elena, Gallant Serge, Tsai Cheng-En, Koski Lisa
The Research Institute of the McGill University Health Centre, McGill University Health Centre, Montreal, Que., Canada.
Dement Geriatr Cogn Disord. 2015;40(3-4):148-57. doi: 10.1159/000381536. Epub 2015 Jun 17.
BACKGROUND/AIMS: No single tool is available in geriatric clinical settings to quantitatively measure global cognitive ability at different stages ranging from normal functioning to severe impairment. We developed an adaptive test to measure cognitive ability in geriatric populations (Geriatric Rapid Adaptive Cognitive Estimate, GRACE); however, the test failed to discriminate between high-functioning individuals. This study aimed to estimate the extent to which adding more difficult items to the GRACE would improve measurement precision in the upper range of cognitive ability.
The original data used to develop the GRACE was merged with newly collected data of patients who presented at local geriatric clinics. The Rasch analysis was used to estimate the difficulty level of the newly added items and evaluate whether the psychometric properties of the GRACE were improved.
One newly added item (Sequencing 5) had a higher difficulty level than all of the previous items in the GRACE. The rest of the new items were located in the high difficulty range.
The psychometric properties of our adaptive screening tool were improved, and we were able to distinguish between individuals who had higher levels of cognitive functioning.
背景/目的：在老年临床环境中，没有单一工具可用于定量测量从正常功能到严重受损的不同阶段的整体认知能力。我们开发了一种适应性测试来测量老年人群的认知能力（老年快速适应性认知评估，GRACE）；然而，该测试未能区分高功能个体。本研究旨在评估在GRACE中增加更难的项目对提高认知能力上限范围内测量精度的程度。
用于开发GRACE的原始数据与当地老年诊所新收集的患者数据合并。采用Rasch分析来估计新添加项目的难度水平，并评估GRACE的心理测量特性是否得到改善。
一个新添加的项目（序列5）的难度水平高于GRACE中所有先前的项目。其余新项目位于高难度范围内。
我们的适应性筛查工具的心理测量特性得到了改善，并且我们能够区分认知功能水平较高的个体。
