Javadi Pari Sadat Haji Seyed, Zendehbad Azadeh, Darabi Fatemeh, Khosravifar Shahrzad, Noroozian Maryam
M.D., Resident of Psychiatry, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran.
M.D., Resident of Geriatric Medicine, Department of Geriatric Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Electron Physician. 2015 Nov 20;7(7):1549-56. doi: 10.19082/1549. eCollection 2015 Nov.
A considerable segment of the elderly population in Iran is illiterate, and it seems the existing neuropsychological screening tests are not very useful for detecting dementia in illiterate participants. The purpose of this study was to develop and validate a tool called Persian test of Elderly for Assessment of Cognition and Executive function (PEACE) for detecting dementia in both illiterate and literate participants.
First, in order to design some of the cognitive aspects of the PEACE assay, we considered other prevalent neuropsychological instruments, such as the General Practitioner assessment of Cognition (GPCOG), Functional Assessment Staging (FAST), Mini Mental State Examination (MMSE), and Wechsler Memory scale. The other domains of PEACE were designed according to our clinical proficiencies and the culture of the society. In the next step, the participants were classified into three distinct groups, i.e., the control group (n=33), the Mild Cognitive Impairment (MCI) group (n=30), and the Alzheimer's group (n=38). All of the participants in each group were divided according to their educational level, i.e., illiterate, semi-literate, and literate.
We developed PEACE consisting of 14 items, each of which represents a specific cognitive function, with a maximum score of 91. The 14 items are Orientation, Praxis, Attention and Concentration, Attention and Calculation, Memory, Similarity, Abstract Thinking, General Information, Language, Judgment, Gnosis, Planning (Sequencing), Problem Solving, and Animal Naming. PEACE scores are highly correlated with those of the MMSE (r=0.78). The optimal cut-off point of PEACE chosen for diagnosis of Alzheimer's disease was 67.5 (sensitivity: 75.8%, specificity: 97.4%). The PEACE scores showed a significant difference between Participants with Alzheimer's disease and the control group (p=0.0000) and the MCI group (p=0.003). In addition, there was no significant difference between illiterate and literate participants in the Alzheimer's group. However, the PEACE scores differed significantly (p=0.0000) between illiterate and literate participants in the control group.
The PEACE addresses the limitations of existing tests and is appropriate for use in countries that have high rates of illiteracy. It is a valid screening mechanism for the detection of dementia in both illiterate and literate participants.
伊朗相当一部分老年人口是文盲，现有的神经心理学筛查测试似乎对检测文盲参与者的痴呆症不太有用。本研究的目的是开发并验证一种名为波斯老年人认知与执行功能评估测试（PEACE）的工具，用于检测文盲和有文化参与者的痴呆症。
首先，为了设计PEACE测试的一些认知方面，我们参考了其他流行的神经心理学工具，如全科医生认知评估（GPCOG）、功能评估分期（FAST）、简易精神状态检查表（MMSE）和韦氏记忆量表。PEACE的其他领域则根据我们的临床经验和社会文化来设计。下一步，参与者被分为三个不同的组，即对照组（n = 33）、轻度认知障碍（MCI）组（n = 30）和阿尔茨海默病组（n = 38）。每组中的所有参与者都根据其教育水平进行划分，即文盲、半文盲和有文化。
我们开发的PEACE由14个项目组成，每个项目代表一种特定的认知功能，最高分为91分。这14个项目分别是定向、动作技能、注意力和专注力、注意力和计算能力、记忆力、相似性、抽象思维、一般知识、语言、判断力、认知、计划（排序）、解决问题和动物命名。PEACE得分与MMSE得分高度相关（r = 0.78）。用于诊断阿尔茨海默病的PEACE最佳截断点为67.5（敏感性：75.8%，特异性：97.4%）。PEACE得分在阿尔茨海默病患者与对照组（p = 0.0000）和MCI组（p = 0.003）之间存在显著差异。此外，阿尔茨海默病组中文盲和有文化参与者之间没有显著差异。然而，对照组中文盲和有文化参与者的PEACE得分存在显著差异（p = 0.0000）。
PEACE解决了现有测试存在的局限性，适用于文盲率较高的国家。它是一种用于检测文盲和有文化参与者痴呆症的有效筛查机制。
