Centre for Healthy Brain Ageing (CheBA), School Of Psychiatry, University of New South Wales, Sydney, New South Wales, 2052, Australia.
School of Psychology, University of Queensland, St Lucia, Queensland, 4072, Australia.
Int J Geriatr Psychiatry. 2020 Nov;35(11):1322-1330. doi: 10.1002/gps.5369. Epub 2020 Jul 30.
The Reading the Mind in the Eyes test (RMET) is a 36-item assessment for theory of mind (ToM) performance. While this measure has been shown to be sensitive to age-related ToM difficulties, there are no established cutoffs or guidelines currently available that are specific to older adults. This article seeks to validate a short-form version of the RMET appropriate for use in such populations.
Cross-sectional data from 295 participants (mean age 86 years) from the Sydney Memory and Ageing Study, a longitudinal community observational cohort. Participants underwent an assessment battery that included the RMET. Individuals who scored >1SD below the RMET scores of cognitively normal participants were deemed to have below average RMET scores. Various model-building methods were used to generate short-form solutions of the RMET, which were compared with previously validated versions in their predictive power for below average full RMET performance.
Individuals with below average RMET performance tended to be older and have poorer global cognition. Of the eight short-form solutions, the 21-item version generated using genetic algorithm exhibited the best classification performance with an area under the receiver operating curve (AUROC) of 0.98 and had 93.2% accuracy in classifying individuals with below average ToM. A shorter 10-item solution derived by ant colony optimization also had acceptable performance.
We recommend the 21-item version of the RMET for use in older adult populations for identifying individuals with impaired ToM. Where an even shorter version is needed with a trade-off of slightly reduced performance, the 10-item version is acceptable.
“读心测试”（Reading the Mind in the Eyes test，RMET）是一种 36 项用于测试心智理论（Theory of Mind，ToM）表现的评估。虽然该测量方法已被证明对与年龄相关的 ToM 困难具有敏感性，但目前尚无针对老年人的特定、既定的截断值或指南。本文旨在验证 RMET 的一种简短形式版本，该版本适用于此类人群。
来自悉尼记忆与衰老研究（Sydney Memory and Ageing Study）的 295 名参与者（平均年龄 86 岁）的横断面数据，这是一个纵向社区观察队列。参与者接受了包括 RMET 在内的评估测试。那些 RMET 得分低于认知正常参与者得分 1 个标准差的个体被认为 RMET 得分低于平均水平。使用各种模型构建方法生成 RMET 的简短形式解决方案，并将其与以前验证的版本在预测低于平均完整 RMET 表现方面进行比较。
RMET 表现低于平均水平的个体往往年龄较大，整体认知能力较差。在八种简短形式解决方案中，使用遗传算法生成的 21 项版本表现出最佳的分类性能，其接受者操作特征曲线（receiver operating characteristic curve，ROC）下面积（area under the receiver operating curve，AUROC）为 0.98，并且在分类 ToM 受损个体方面的准确率为 93.2%。通过蚁群优化得到的更简短的 10 项解决方案也具有可接受的性能。
我们建议在老年人群中使用 RMET 的 21 项版本来识别心智理论受损的个体。如果需要一个更简短的版本，并且以稍微降低性能为代价，那么 10 项版本是可以接受的。
