Reppermund Simone, Birch Rachael C, Crawford John D, Wesson Jacqueline, Draper Brian, Kochan Nicole A, Trollor Julian N, Luttenberger Katharina, Brodaty Henry, Sachdev Perminder S
Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, Sydney, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, Sydney, Australia.
Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, Sydney, Australia.
J Am Med Dir Assoc. 2017 Feb 1;18(2):117-122. doi: 10.1016/j.jamda.2016.08.007. Epub 2016 Oct 6.
The distinction between dementia and mild cognitive impairment (MCI) relies upon the evaluation of independence in instrumental activities of daily living (IADL). Self- and informant reports are prone to bias. Clinician-based performance tests are limited by long administration times, restricted access, or inadequate validation. To close this gap, we developed and validated a performance-based measure of IADL, the Sydney Test of Activities of Daily Living in Memory Disorders (STAM).
Prospective cohort study (Sydney Memory and Ageing Study).
Eastern Suburbs, Sydney, Australia.
554 community-dwelling individuals (54% female) aged 76 and older with normal cognition, MCI, or dementia.
Activities of daily living were assessed with the STAM, administered by trained psychologists, and the informant-based Bayer-Activities of Daily Living Scale (B-ADL). Depressive symptoms were measured with the Geriatric Depression Scale (15-item version). Cognitive function was assessed with a comprehensive neuropsychological test battery. Consensus diagnoses of MCI and dementia were made independently of STAM scores.
The STAM showed high interrater reliability (r = 0.854) and test-retest reliability (r = 0.832). It discriminated significantly between the diagnostic groups of normal cognition, MCI, and dementia with areas under the curves ranging from 0.723 to 0.948. A score of 26.5 discriminated between dementia and nondementia with a sensitivity of 0.831 and a specificity of 0.864. Correlations were low with education (r = 0.230) and depressive symptoms (r = -0.179), moderate with the B-ADL (r = -0.332), and high with cognition (ranging from r = 0.511 to r = 0.594). The mean time to complete the STAM was 16 minutes.
The STAM has good psychometric properties. It can be used to differentiate between normal cognition, MCI, and dementia and can be a helpful tool for diagnostic classification both in clinical practice and research.
痴呆与轻度认知障碍（MCI）的区分依赖于对日常生活工具性活动（IADL）独立性的评估。自我报告和知情者报告容易出现偏差。基于临床医生的表现测试受到测试时间长、获取受限或验证不足的限制。为了弥补这一差距，我们开发并验证了一种基于表现的IADL测量方法，即记忆障碍日常生活悉尼测试（STAM）。
前瞻性队列研究（悉尼记忆与衰老研究）。
澳大利亚悉尼东郊。
554名年龄在76岁及以上的社区居住个体（54%为女性），认知功能正常、患有MCI或痴呆。
通过由训练有素的心理学家实施的STAM以及基于知情者的拜耳日常生活活动量表（B-ADL）评估日常生活活动。用老年抑郁量表（15项版本）测量抑郁症状。用一套全面的神经心理测试电池评估认知功能。MCI和痴呆的共识诊断独立于STAM分数做出。
STAM显示出较高的评分者间信度（r = 0.854）和重测信度（r = 0.832）。它在认知功能正常、MCI和痴呆的诊断组之间有显著差异，曲线下面积范围为0.723至0.948。26.5分可区分痴呆和非痴呆，敏感性为0.831，特异性为0.864。与教育程度的相关性较低（r = 0.230），与抑郁症状的相关性较低（r = -0.179），与B-ADL的相关性中等（r = -0.332），与认知的相关性较高（r范围从0.511至0.594）。完成STAM的平均时间为16分钟。
STAM具有良好的心理测量特性。它可用于区分正常认知、MCI和痴呆，并且在临床实践和研究中都可以成为诊断分类的有用工具。
