School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Department of Family Medicine and Rush Alzheimer's Disease Center; Rush University Medical Center, Chicago, IL, USA.
J Alzheimers Dis. 2022;87(4):1683-1693. doi: 10.3233/JAD-215564.
Cognitive test-retest reliability measures can be used to evaluate meaningful changes in scores.
This analysis aimed to develop a comprehensive set of test-retest reliability values and minimal detectable change (MDC) values for a cognitive battery for community-dwelling older individuals in Australia and the U.S., for use in clinical practice.
Cognitive scores collected at baseline and year 1, in the ASPirin in Reducing Events in the Elderly clinical trial were used to calculate intraclass correlation coefficients (ICC) for four tests: Modified Mini-Mental State examination (3MS), Hopkins Verbal Learning Test-Revised (HVLT-R), single-letter Controlled Oral Word Association Test (COWAT-F), and Symbol Digit Modalities Test (SDMT). 16,956 participants aged 70 years and over (65 years and over for U.S. minorities) were included. ICCs were used to calculate MDC values for eight education and ethno-racial subgroups.
All four cognitive tests had moderate (ICC > 0.5) to good (ICC > 0.7) test-retest reliability. ICCs ranged from 0.53 to 0.63 (3MS), 0.68 to 0.77 (SDMT), 0.56 to 0.64 (COWAT-F), 0.57 to 0.69 (HVLT-R total recall), and 0.57 to 0.70 (HVLT-R delayed recall) across the subgroups. MDC values ranged from 6.60 to 9.95 (3MS), 12.42 to 15.61 (SDMT), 6.34 to 8.34 (COWAT-F), 8.13 to 10.85 (HVLT-R total recall), and 4.00 to 5.62 (HVLT-R delayed recall).
This large cohort of older individuals provides test-retest reliability and MDC values for four widely employed tests of cognitive function. These results can aid interpretation of cognitive scores and decline instead of relying on cross-sectional normative data alone.
认知测试重测信度可以用于评估分数的有意义变化。
本分析旨在为澳大利亚和美国的社区居住的老年个体的认知电池建立一套全面的重测信度值和最小可检测变化（MDC）值，以便用于临床实践。
使用 ASPirin in Reducing Events in the Elderly 临床试验中基线和第 1 年收集的认知评分，计算四项测试的组内相关系数（ICC）：改良简易精神状态检查（3MS）、霍普金斯词语学习测试修订版（HVLT-R）、单字母受控口头单词联想测试（COWAT-F）和符号数字模态测试（SDMT）。共纳入 16,956 名年龄在 70 岁及以上（美国少数民族为 65 岁及以上）的参与者。使用 ICC 计算八个教育和种族亚组的 MDC 值。
四项认知测试的重测信度均为中度（ICC>0.5）至良好（ICC>0.7）。ICC 范围为 0.53 至 0.63（3MS）、0.68 至 0.77（SDMT）、0.56 至 0.64（COWAT-F）、0.57 至 0.69（HVLT-R 总回忆）和 0.57 至 0.70（HVLT-R 延迟回忆）。MDC 值范围为 6.60 至 9.95（3MS）、12.42 至 15.61（SDMT）、6.34 至 8.34（COWAT-F）、8.13 至 10.85（HVLT-R 总回忆）和 4.00 至 5.62（HVLT-R 延迟回忆）。
本研究中大量的老年个体提供了四项广泛应用的认知功能测试的重测信度和 MDC 值。这些结果可以帮助解释认知分数和下降，而不仅仅依赖于横断面的标准数据。
