Research Institute for the Care of Older People (RICE), Bath, UK.
Institute of Clinical Neurosciences, University of Bristol, Bristol, UK.
Int Psychogeriatr. 2021 Nov;33(11):1145-1159. doi: 10.1017/S1041610221000302. Epub 2021 Apr 5.
In diagnosing dementia, estimating premorbid functioning is critical for accurate detection of the presence and severity of cognitive decline. However, which assessments of premorbid intelligence are most suitable for use in clinical practice is not well established. Here, we systematically evaluate the validity of instruments for measuring premorbid intelligence in people living with dementia.
In this systematic review, electronic databases (EMBASE, PsycINFO, MEDLINE, CINAHL, and AMED) were searched to identify studies reporting on objective measures of premorbid intelligence in dementia. Participants from included studies were recruited from local communities and clinical settings.
A total of 1082 patients with dementia and 2587 healthy controls were included in the review.
The literature search resulted in 13 eligible studies describing 19 different instruments. The majority of instruments (n = 14) consisted of language-based measures, with versions of the National Adult Reading Test (NART) being most commonly investigated.
Preliminary evidence suggested comparable performance of patients with mild dementia and healthy controls on word reading tasks in English, Portuguese, Swedish, and Japanese. In moderate dementia, however, the performance was significantly impaired on most verbal tasks. There was a lack of reliability and validity testing of available instruments, with only one of the included studies reporting psychometric properties within the patient group.
The results demonstrate that there is a wide range of tools available for estimating premorbid intelligence in dementia, with cautious support for the potential of word reading tasks across different languages in individuals with mild dementia. However, the review highlights the urgent need for extensive assessments of the psychometric properties of these tasks in dementia. We propose that further longitudinal research and assessments of nonverbal measures are necessary to validate these instruments and enhance diagnostic procedures for people living with dementia worldwide.
在诊断痴呆症时，评估发病前的功能对于准确发现认知能力下降的存在和严重程度至关重要。然而，哪些发病前智力评估最适合用于临床实践尚不清楚。在这里，我们系统地评估了用于测量痴呆症患者发病前智力的工具的有效性。
在这项系统评价中，检索了电子数据库（EMBASE、PsycINFO、MEDLINE、CINAHL 和 AMED），以确定报告痴呆症患者客观发病前智力测量的研究。纳入研究的参与者是从当地社区和临床环境中招募的。
共有 1082 名痴呆症患者和 2587 名健康对照者纳入了本综述。
文献检索共产生了 13 项符合条件的研究，描述了 19 种不同的工具。大多数工具（n=14）由语言为基础的测量组成，其中国家成人阅读测验（NART）的版本是最常被研究的。
初步证据表明，在英语、葡萄牙语、瑞典语和日语中，轻度痴呆症患者和健康对照组在单词阅读任务上的表现相当。然而，在中度痴呆症中，大多数言语任务的表现明显受损。目前可用工具的可靠性和有效性测试缺乏，只有一项纳入的研究报告了患者组内的心理测量特性。
结果表明，有广泛的工具可用于估计痴呆症中的发病前智力，谨慎地支持轻度痴呆症个体中不同语言的单词阅读任务的潜力。然而，综述强调了迫切需要对这些任务在痴呆症中的心理测量特性进行广泛评估。我们建议进一步进行纵向研究和非言语测量评估，以验证这些工具，并增强全球痴呆症患者的诊断程序。
