Department of Neurobiology,Care Sciences and Society,Division of Occupational Therapy,Karolinska Institutet,Huddinge,Sweden.
Department of Neurobiology,Care Sciences and Society,Division of Clinical Geriatrics,Karolinska Institutet,Huddinge,Sweden.
Int Psychogeriatr. 2018 Oct;30(10):1447-1454. doi: 10.1017/S1041610218000285. Epub 2018 Apr 4.
ABSTRACTBackground:In clinical practice, efficient and valid functional markers are needed to detect subtle cognitive and functional decline in mild cognitive impairment (MCI). This prospective study explored whether changes in perceived challenge of certain everyday technologies (ETs) can be used to detect signs of functional change in MCI.
Baseline and five-year data from 37 older adults (mean age 67.5 years) with MCI regarding their perceived ability to use ET were used to generate Rasch-based ET item measures reflecting the relative challenge of 46 ETs. Actual differential item functioning in relation to time was analyzed based on these item measures. Data collection took place in 2008-2014.
Seven (15%) of the ETs included were perceived to be significantly more challenging to use at year five compared to at baseline, while 39 ETs (85%) were perceived to be equally challenging to use, despite the fact that the participants' perceived ability to use ET had decreased. Common characteristics among the ETs that became more challenging to use could not be identified. The dropout rate was 43%, which limits the power of the study.
Changes in the perceived challenge of ETs seem to capture functional change in persons with cognitive decline. Both easier and more challenging ETs typically used at home and in society need to be addressed to capture this functional change because significant changes occurred among ETs of all challenge levels and within all types of ETs.
摘要背景：在临床实践中，需要有效的、有针对性的功能标志物来检测轻度认知障碍（MCI）患者认知和功能的细微变化。本前瞻性研究旨在探讨感知日常生活技术（ET）挑战的变化是否可用于检测 MCI 患者的功能变化迹象。方法：本研究使用了 37 名患有 MCI 的老年人（平均年龄 67.5 岁）的基线和五年数据，以评估他们感知使用 ET 的能力，从而生成反映 46 项 ET 相对挑战的基于 Rasch 的 ET 项目度量。基于这些项目度量，分析了与时间相关的实际差异项目功能。数据收集于 2008-2014 年进行。结果：有 7 项（15%）ET 在五年后被感知比基线时更具挑战性，而 39 项（85%）ET 则被感知为具有相同的挑战性，尽管参与者感知使用 ET 的能力已经下降。无法确定变得更具挑战性的 ET 具有哪些共同特征。失访率为 43%，这限制了研究的效力。结论：ET 感知挑战的变化似乎可以捕捉认知下降患者的功能变化。因为所有难度级别的 ET 和各种类型的 ET 都发生了显著变化，因此需要同时考虑到家庭和社会中通常使用的更简单和更具挑战性的 ET，以捕捉这种功能变化。
