Taiwan Catholic Foundation of Alzheimer's Disease and Related Dementia, Taiwan.
School of Medicine, Fu Jen Catholic University, Taiwan; Department of Neurology, Cardinal Tien Hospital, Taiwan.
J Formos Med Assoc. 2018 Jan;117(1):42-47. doi: 10.1016/j.jfma.2017.02.015. Epub 2017 Mar 21.
BACKGROUND/PURPOSE: Screening of dementia can help to initiate proper management of the disorder. The use of the Ascertain Dementia 8-item Questionnaire (AD8) in screening has been promoted in Taiwan recently. The purpose of this study was to compare the psychometric properties and appropriateness of informant-reported and self-rated AD8 in cognitive impairment screening in Taiwan.
The AD8 were administered to 153 participants and their informants recruited from two neurology out-patient clinics. The discriminative abilities for early cognitive impairment [Clinical Dementia Rating scale (CDR) 0.5 and 1] of informant-based and self-rating AD8 were determined and compared with their areas under the receiver operating curve. κ coefficients representing the agreement between self-rated and informant-reported AD8 scores were also calculated.
Participants and their informants were aged 76.9 years and 56.0 years on average, respectively. Only informant-reported AD8 was significantly associated with CDR level (Spearman ρ=0.469, p<0.001) and Cognitive Abilities Screening Instrument score (Spearman ρ=-0.458, p<0.001). The item-by-item agreements between self-rated and informant-reported AD8 were poor (κ coefficients: -0.030 to 0.206). The area under the receiver-operator characteristic curve was 0.59 for self-rated AD8 scores, and 0.77 for informant-reported AD8 scores, indicating that the discriminating ability of AD8 scores between CDR 0 and CDR 0.5 or greater is better when reported by informant than when rated by self.
Informant-rated AD8 gave more accurate screening results than self-reported AD8 in an out-patient clinic setting.
背景/目的：痴呆症的筛查有助于对该疾病进行适当的管理。最近，在台湾，人们提倡使用 8 项简易认知障碍筛查量表（AD8）进行筛查。本研究的目的是比较在台湾使用知情者报告和自我报告的 AD8 进行认知障碍筛查的心理测量学特性和适宜性。
在两家神经内科门诊招募了 153 名参与者及其知情者，对他们进行 AD8 评估。确定并比较了知情者报告和自我报告的 AD8 对早期认知障碍（临床痴呆评定量表（CDR）0.5 和 1）的区分能力，并计算了其接受者操作特征曲线下的面积。还计算了自我报告和知情者报告的 AD8 得分之间的一致性的 κ 系数。
参与者及其知情者的平均年龄分别为 76.9 岁和 56.0 岁。只有知情者报告的 AD8 与 CDR 水平（Spearman ρ=0.469，p<0.001）和认知能力筛查工具评分（Spearman ρ=-0.458，p<0.001）显著相关。自我报告和知情者报告的 AD8 之间的各项指标之间的一致性较差（κ 系数：-0.030 至 0.206）。自我报告的 AD8 评分的受试者工作特征曲线下面积为 0.59，知情者报告的 AD8 评分的面积为 0.77，这表明在门诊环境中，AD8 评分在 CDR 0 与 CDR 0.5 或更高之间的区分能力，由知情者报告比自我报告更准确。
在门诊环境中，知情者评定的 AD8 比自我报告的 AD8 能提供更准确的筛查结果。
