Park Jinse, Choi Hojin, Jang Jea Won, Lim Jae Sung, Yang YoungSoon, Lee Chan Nyoung, Park Kee Hyung
Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Korea.
Department of Neurology, Hanyang University Guri Hospital, Guri, Korea.
J Clin Neurol. 2021 Jan;17(1):106-112. doi: 10.3988/jcn.2021.17.1.106.
Screening tests for dementia such as the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment are widely used, but there are drawbacks to their efficient use. There remains a need for a brief and easy method of assessing the activities of daily living (ADL) that can be administered to elderly individuals by healthcare workers. We have therefore developed a new scale named the Simple Observation Checklist for Activities of Daily Living (SOC-ADL).
We developed the SOC-ADL scale as a team of experts engaged in caring for individuals with dementia. This scale comprises eight items and was designed based on the Korean instrumental activities of daily living (K-IADL) scale and the Barthel activities of daily living scale (Barthel Index). The new scale was validated by enrolling 176 patients with cognitive dysfunction across 6 centers. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were performed. We assessed its concurrent validity by performing comparisons with the Korean-MMSE, Clinical Dementia Rating, Clinical Dementia Rating-Sum of Boxes, K-IADL, and Barthel Index, and its criterion validity by performing comparisons between mild cognitive impairment (MCI) and dementia. We also used Cronbach's alpha to assess the interitem reliability. The appropriate cutoff values were determined by analyzing receiver operating characteristic curves, including the areas underneath them.
EFA extracted one factor and CFA revealed that all of the model fits exceeded the minimum acceptable criteria. The SOC-ADL scores were strongly correlated with those of the other tools for dementia and could be used to differentiate MCI from dementia. Cronbach's alpha values indicated that the results were reliable. The optimal cutoff value of the SOC-ADL for discriminating dementia from MCI was 3 points, which provided a sensitivity and specificity of 74.5% and 75.7%, respectively.
Our results demonstrate that the SOC-ADL is a valid and reliable tool for differentiating dementia from MCI based on an assessment of ADL. This new tool can be used for screening ADL in elderly subjects who have difficulty communicating, and to increase the efficiency of dementia screening at the population level.
用于痴呆筛查的测试，如简易精神状态检查表（MMSE）和蒙特利尔认知评估量表被广泛使用，但在有效使用方面存在缺陷。仍需要一种简短且易于实施的日常生活活动（ADL）评估方法，可供医护人员对老年人进行测评。因此，我们开发了一种名为日常生活活动简易观察检查表（SOC - ADL）的新量表。
我们作为一个照顾痴呆患者的专家团队开发了SOC - ADL量表。该量表包含八个项目，基于韩国日常生活工具性活动（K - IADL）量表和巴氏日常生活活动量表（巴氏指数）设计而成。通过纳入6个中心的176例认知功能障碍患者对新量表进行验证。进行了验证性因子分析（CFA）和探索性因子分析（EFA）。通过与韩国MMSE、临床痴呆评定量表、临床痴呆评定量表 - 框和（CDR - SUMB）、K - IADL以及巴氏指数进行比较来评估其同时效度，通过比较轻度认知障碍（MCI）和痴呆来评估其效标效度。我们还使用克朗巴赫α系数来评估项目间信度。通过分析受试者工作特征曲线（包括曲线下面积）确定合适的截断值。
EFA提取出一个因子，CFA显示所有模型拟合均超过最低可接受标准。SOC - ADL得分与其他痴呆工具得分高度相关，可用于区分MCI和痴呆。克朗巴赫α系数值表明结果可靠。用于区分痴呆和MCI的SOC - ADL最佳截断值为3分，其灵敏度和特异度分别为74.5%和75.7%。
我们的结果表明，SOC - ADL是一种基于ADL评估区分痴呆和MCI的有效且可靠的工具。这种新工具可用于筛查沟通困难的老年受试者的ADL，并提高人群层面痴呆筛查的效率。
