Ashford J W, Kolm P, Colliver J A, Bekian C, Hsu L N
School of Medicine, Southern Illinois University.
J Gerontol. 1989 Sep;44(5):P139-46. doi: 10.1093/geronj/44.5.p139.
To develop a tool for precisely assessing dementia severity, items should be selected according to their relationship to the overall progression of the disease. Using an item characteristic curve analysis (ICC), items were examined from the Folstein Mini-Mental State Exam (MMSE), a useful clinical tool for evaluating dementia. MMSE data were available for 86 patients who met DSM-III criteria for primary degenerative dementia -- possible or probable Alzheimer's disease (AD). A logistic regression analysis of the probability of correct performance on an item, given the total MMSE score, yielded statistics for difficulty and discrimination. These statistics were interpreted respectively as indicators of the point in the progression of the illness at which the mental function tested by that item is lost and the rapidity of that loss. The data indicated a systematic progression of the development of symptoms in AD related to decline of memory function. Temporal orientation was lost before spatial and object orientation, and recollection of words was lost before ability to repeat them. ICC can help to delineate the loss of mental functions during the course of AD.
为开发一种精确评估痴呆严重程度的工具，应根据项目与疾病整体进展的关系来选择项目。使用项目特征曲线分析（ICC），从简易精神状态检查表（MMSE）中选取项目进行研究，MMSE是评估痴呆的一种有用的临床工具。有86名符合原发性退行性痴呆——可能或很可能为阿尔茨海默病（AD）的DSM-III标准的患者的MMSE数据。对给定MMSE总分时项目正确完成概率的逻辑回归分析得出了难度和区分度统计数据。这些统计数据分别被解释为该项目所测试的心理功能在疾病进展过程中丧失的时间点以及丧失速度的指标。数据表明，与记忆功能衰退相关的AD症状发展呈系统性进展。时间定向在空间和物体定向之前丧失，单词回忆在重复能力之前丧失。ICC有助于描绘AD病程中心理功能的丧失情况。
