帕金森病临床痴呆评定量表盒式评分的心理测量特性。
Psychometric Properties of the Clinical Dementia Rating Scale Sum of Boxes in Parkinson's Disease.
机构信息
Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
出版信息
J Parkinsons Dis. 2021;11(2):737-745. doi: 10.3233/JPD-202390.
BACKGROUND
A composite measure that assesses both cognitive and functional abilities in Parkinson's disease (PD) would be useful for diagnosing mild cognitive impairment (MCI) and PD dementia (PDD) and as an outcome measure in randomized controlled trials. The Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) was designed to assess both cognition and basic-instrumental activities of daily living in Alzheimer's disease but has not yet been validated in PD.
OBJECTIVE
To validate the CDR-SOB as a composite cognitive-functional measure for PD patients, as well as to assess its sensitivity to change.
METHODS
The CDR-SOB and a comprehensive cognitive and functional battery was administered to 101 PD patients at baseline (39 normal cognition [NC], 41 MCI and 21 PDD by expert consensus panel), and re-administered to 64 patients after 1-2 years follow-up (32 NC and 32 cognitive impairment [CI] at baseline).
RESULTS
Cross-sectionally, CDR-SOB and domain scores were correlated with corresponding neuropsychological or functional measures and were significantly different between cognitive subgroups both at baseline and at follow-up. In addition, CDR-SOB ROC curves distinguished between normal cognition and dementia with high sensitivity, but did not distinguish well between NC and MCI. Longitudinal changes in the CDR-SOB and domain scores were not significant and were inconsistent in predicting change in commonly-used cognitive and functional tests.
CONCLUSION
The CDR-SOB detects dementia-level cognitive impairment in PD but may not be appropriate for predicting longitudinal combined cognitive-functional changes in patients without significant cognitive impairment at baseline.
背景
评估帕金森病（PD）患者认知和功能能力的综合指标，将有助于诊断轻度认知障碍（MCI）和 PD 痴呆（PDD），并作为随机对照试验的结局指标。临床痴呆评定量表总和评分（CDR-SOB）旨在评估阿尔茨海默病患者的认知和基本工具性日常生活活动能力，但尚未在 PD 中得到验证。
目的
验证 CDR-SOB 作为 PD 患者综合认知-功能测量指标的有效性，并评估其对变化的敏感性。
方法
101 例 PD 患者在基线时接受 CDR-SOB 和全面认知和功能检查（39 例认知正常[NC]、41 例 MCI 和 21 例 PDD 经专家共识小组诊断），64 例患者在 1-2 年随访时接受再评估（32 例 NC 和 32 例基线时认知障碍[CI]）。
结果
在横断面上，CDR-SOB 和各域评分与相应的神经心理学或功能测量值相关，且在认知亚组中，无论是在基线还是随访时，与各域评分之间均存在显著差异。此外，CDR-SOB 的 ROC 曲线能够区分正常认知和痴呆，具有较高的敏感性，但无法很好地区分 NC 和 MCI。CDR-SOB 和各域评分的纵向变化不显著，且不能很好地预测常用认知和功能测试的变化。
结论
CDR-SOB 可检测 PD 患者痴呆水平的认知障碍，但对于预测基线时无明显认知障碍的患者的纵向综合认知-功能变化可能并不合适。
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