Suzuki Yukiko, Teruya Koji, Mochizuki Hideki, Nagasawa Akira, Kondo Tomoko, Shimoda Nobuaki
Department of Occupational Therapy, Kyorin University, Tokyo, Japan.
Department of Public Health, Faculty of Health Sciences, Kyorin University, Tokyo, Japan.
Dement Geriatr Cogn Dis Extra. 2019 Jun 21;9(2):227-235. doi: 10.1159/000500019. eCollection 2019 May-Aug.
The aim of this study was to determine Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL) evaluations that will enable better understanding of the severity of Alzheimer's disease (AD).
AD patients were evaluated by Functional Independence Measure (FIM), Hyogo Activities of Daily Living Scale (HADLS), and Assessment of Motor and Process Skills (AMPS) to identify the assessments that will enable highly precise discrimination of AD Clinical Dementia Rating (CDR) 2 (moderate) and CDR3 (severe) using receiver operating characteristic (ROC) curve and discriminant analyses.
The participants were 75 AD patients (CDR2 = 50, mean age = 80.3 ± 5.9 years; CDR3 = 25, mean age = 78.3 ± 9.0 years). The evaluation methods consisted of FIM, HADLS, and AMPS. The results were divided into FIM-M, FIM-C, HADLS-ADL, HADLS-IADL, AMPS-motor skills, and AMPS-process skills. The values for the area under the curve (AUC) were compared by ROC curve and discriminant analyses. AUC values for FIM-C and AMPS-process skills were 0.956 and 0.947, respectively. With these two evaluations only, values ≥0.9 were shown. Moreover, the AUC of the discrimination score (combination of the FIM-C and AMPS-process skills) was significantly higher than those for FIM-M, FIM-C, HADLS-ADL, HADLS-IADL, and AMPS-motor skills.
The results demonstrated that evaluation by FIM-C and AMPS-process skills methods was useful for discriminating between CDR2 (moderate) and CDR3 (severe) AD. Moreover, the results indicated that these two evaluation methods enabled more accurate determination of severity and the spared capabilities of AD patients.
本研究旨在确定日常生活活动/工具性日常生活活动（ADL/IADL）评估方法，以更好地了解阿尔茨海默病（AD）的严重程度。
采用功能独立性测量（FIM）、兵库日常生活活动量表（HADLS）和运动及过程技能评估（AMPS）对AD患者进行评估，通过受试者工作特征（ROC）曲线和判别分析，确定能够高度精确区分AD临床痴呆评定量表（CDR）2级（中度）和CDR3级（重度）的评估方法。
研究对象为75例AD患者（CDR2级50例，平均年龄80.3±5.9岁；CDR3级25例，平均年龄78.3±9.0岁）。评估方法包括FIM、HADLS和AMPS。结果分为FIM-运动、FIM-认知、HADLS-ADL、HADLS-IADL、AMPS-运动技能和AMPS-过程技能。通过ROC曲线和判别分析比较曲线下面积（AUC）值。FIM-认知和AMPS-过程技能的AUC值分别为0.956和0.947。仅通过这两项评估，显示值≥0.9。此外，判别分数（FIM-认知和AMPS-过程技能的组合）的AUC显著高于FIM-运动、FIM-认知、HADLS-ADL、HADLS-IADL和AMPS-运动技能。
结果表明，采用FIM-认知和AMPS-过程技能方法进行评估有助于区分CDR2级（中度）和CDR3级（重度）AD。此外，结果表明这两种评估方法能够更准确地确定AD患者的严重程度和保留能力。
