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《谵妄:一项横断面研究,比较严重认知障碍评定量表与简易精神状态检查和修订版谵妄评定量表-98 用于评估谵妄》

A Comparison of the Severe Cognitive Impairment Rating Scale With the Mini-Mental State Examination and Delirium Rating Scale-Revised-98 for Delirium: A Cross-sectional Study.

机构信息

Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea.

Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea.

出版信息

Psychosomatics. 2017 Nov-Dec;58(6):643-651. doi: 10.1016/j.psym.2017.08.002. Epub 2017 Aug 5.

Abstract

BACKGROUND

Cognitive impairment including attention deficits, disorientation, memory impairment, language disturbance, and impaired visuospatial ability are core symptoms of delirium. The Severe Cognitive Impairment Rating Scale (SCIRS) was developed to assess cognition in patients with severe dementia, but may also be useful in elderly people with delirium.

OBJECTIVE

We investigated the use of the SCIRS to assess cognition in elderly patients with delirium.

METHODS

We recruited 147 participants, aged ≥65 years, referred for psychiatric consultation at a tertiary-care university hospital. The diagnosis and severity of delirium were assessed using the Korean version of the Delirium Rating Scale-Revised-98 (K-DRS-98). Cognitive function was assessed using the SCIRS and the Mini-Mental State Examination (MMSE) in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Assessment Packet (MMSE-KC).

RESULTS

There was a strong correlation of SCIRS scores with K-DRS-98 cognition domain (r = -0.796), severity scores (r = -0.742), total scores (r = -0.734), and the MMSE-KC (r = 0.905). Analysis of variance incorporating the severity of delirium suggested that while the MMSE showed a floor effect, the SCIRS could discriminate between moderate and severe delirium.

CONCLUSION

The SCIRS is a useful instrument to assess cognitive function in elderly patients with moderate to severe delirium.

摘要

背景

认知障碍包括注意力缺陷、定向障碍、记忆障碍、语言障碍和视空间能力受损,是谵妄的核心症状。严重认知障碍评定量表(SCIRS)是为评估严重痴呆患者的认知功能而开发的,但也可能对患有谵妄的老年患者有用。

目的

我们研究了 SCIRS 在评估老年谵妄患者认知功能中的应用。

方法

我们招募了 147 名年龄≥65 岁的参与者,他们在一家三级护理大学医院接受精神科咨询。使用韩国版谵妄评定量表修订版-98(K-DRS-98)评估谵妄的诊断和严重程度。使用 SCIRS 和 Consortium to Establish a Registry for Alzheimer's Disease(CERAD)评估包的韩国版简易精神状态检查(MMSE-KC)评估认知功能。

结果

SCIRS 评分与 K-DRS-98 认知域(r = -0.796)、严重程度评分(r = -0.742)、总分(r = -0.734)和 MMSE-KC(r = 0.905)呈强相关。考虑到谵妄严重程度的方差分析表明,虽然 MMSE 表现出地板效应,但 SCIRS 可以区分中度和重度谵妄。

结论

SCIRS 是评估中度至重度谵妄老年患者认知功能的有用工具。

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