Department of Psychiatry and Behavioral Sciences,Johns Hopkins University School of Medicine,Baltimore,MD,USA.
University of Texas Southwestern Medical School,Dallas,Texas,USA.
Int Psychogeriatr. 2017 Jul;29(7):1169-1174. doi: 10.1017/S1041610217000151. Epub 2017 Mar 29.
Alzheimer's disease has become an important public health burden for older adults. Clinicians face a challenging task to efficiently evaluate cognition in dementia in clinical settings. We sought to assess the validity and inter-correlations of brief cognitive assessments in a cohort of severely demented patients.
In total, 49 individual patients (N = 49) ranging in age from 62 to 97 years old were included in this performance improvement project. Over the course of two-three sessions, five cognitive instruments were administered to each patient: Severe Impairment Battery (SIB), Severe Impairment Battery-8 (SIB-8), Mini Mental State Examination (MMSE), Severe Mini Mental State Examination (sMMSE) and Brief Interview of Mental Status (BIMS). We sought to assess patient factors that might have been barriers to optimal performance on cognitive/functional tests. Researchers assessed her impression of the participants' difficulty comprehending instructions, distractibility, apparent fatigue, and frustration, which were the four barriers rated.
Data were analyzed for 49 patients from the inpatient dementia unit with a total of 51 samples. All of the inter-correlations between the five cognitive instruments had Spearman coefficients of (rs) > 0.7 and were statistically significant with p < 0.001. The SIB-8 and sMMSE were positively correlated with the SIB. The perceived barrier scores ranged from 0- no issue to 1-mild issue on all five cognitive instruments.
Brief cognitive tests designed for severe dementia such as the SIB-8 and sMMSE have been evaluated in this project to be shorter in administration duration and highly correlated with gold standard instruments: the SIB and MMSE.
阿尔茨海默病已成为老年人的一个重要公共卫生负担。临床医生在临床环境中面临着有效评估痴呆认知的艰巨任务。我们旨在评估严重痴呆患者队列中简短认知评估的有效性和相关性。
在这个绩效改进项目中，共纳入了 49 名年龄在 62 至 97 岁之间的个体患者（N=49）。在两到三个会话中，对每位患者进行了五项认知测试：严重障碍电池测试（SIB）、严重障碍电池-8 测试（SIB-8）、简易精神状态检查（MMSE）、严重简易精神状态检查（sMMSE）和简短精神状态访谈（BIMS）。我们试图评估可能成为认知/功能测试最佳表现障碍的患者因素。研究人员评估了患者理解指令、注意力分散、明显疲劳和沮丧的障碍程度，这四个障碍的评分分别为 0-没有问题到 1-轻度问题。
对来自住院痴呆病房的 49 名患者进行了数据分析，共分析了 51 个样本。五种认知工具之间的所有相关性均具有 Spearman 系数(rs)＞0.7，且具有统计学意义（p＜0.001）。SIB-8 和 sMMSE 与 SIB 呈正相关。在所有五项认知测试中，感知障碍得分的范围为 0-无问题到 1-轻度问题。
在这个项目中，为严重痴呆设计的简短认知测试，如 SIB-8 和 sMMSE，已被评估为具有较短的测试时长，且与金标准工具：SIB 和 MMSE 高度相关。
