自报血管风险因素（高血压、糖尿病和心脏病）的可靠性和有效性：一项基于多民族社区的老龄化和痴呆症研究。
Reliability and Validity of Self-Reported Vascular Risk Factors: Hypertension, Diabetes, and Heart Disease, in a Multi-Ethnic Community Based Study of Aging and Dementia.
机构信息
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
出版信息
J Alzheimers Dis. 2023;95(1):275-285. doi: 10.3233/JAD-230374.
BACKGROUND
Queries for the presence of cardiovascular and cerebrovascular risk factors are typically assessed through self-report. However, the reliability and validity of self-reported cardiovascular and cerebrovascular risk factors remain inconsistent in aging research.
OBJECTIVE
To determine the reliability and validity of the most frequently self-reported vascular risk factors: hypertension, diabetes, and heart disease.
METHODS
1,870 individuals aged 65 years or older among African Americans, Caribbean Hispanics, and white non-Hispanic individuals were recruited as part of a community study of aging and dementia. We assessed the reliability, validity, sensitivity, specificity, and percent agreement of self-reported hypertension, diabetes, and heart disease, in comparison with direct measures of blood pressure, hemoglobin A1c (HbA1c), and medication use. The analyses were subsequently stratified by age, sex, education, and ethnic group.
RESULTS
Reliability of self-reported hypertension, diabetes, and heart disease was excellent. Agreement between self-reports and clinical measures was moderate for hypertension (kappa: 0.58), good for diabetes (kappa: 0.76-0.79), and moderate for heart disease (kappa: 0.45) differing slightly by age, sex, education, and ethnic group. Sensitivity and specificity for hypertension was 88.6% -78.1%, for diabetes was 87.7% -92.0% (HbA1c ≥6.5%) or 92.7% -92.8% (HbA1c ≥7%), and for heart disease was 85.8% -75.5%. Percent agreement of self-reported was 87.0% for hypertension, 91.6% -92.6% for diabetes, and 77.4% for heart disease.
CONCLUSION
Ascertainment of self-reported histories of hypertension, diabetes, and heart disease are reliable and valid compared to direct measurements or medication use.
背景
心血管和脑血管危险因素的查询通常通过自我报告进行评估。然而，在衰老研究中，自我报告的心血管和脑血管危险因素的可靠性和有效性仍然不一致。
目的
确定最常报告的血管危险因素（高血压、糖尿病和心脏病）的可靠性和有效性。
方法
作为一项老龄化和痴呆症社区研究的一部分，招募了 1870 名年龄在 65 岁或以上的非裔美国人、加勒比西班牙裔和白种非西班牙裔个体。我们评估了自我报告的高血压、糖尿病和心脏病的可靠性、有效性、敏感性、特异性和百分比一致性，与血压、糖化血红蛋白（HbA1c）和药物使用的直接测量值进行比较。分析随后按年龄、性别、教育程度和族裔群体进行分层。
结果
自我报告的高血压、糖尿病和心脏病的可靠性非常好。自我报告与临床测量之间的一致性对于高血压为中度（kappa：0.58），对于糖尿病为良好（kappa：0.76-0.79），对于心脏病为中度（kappa：0.45），差异略有差异年龄、性别、教育程度和族裔群体。高血压的敏感性和特异性为 88.6%-78.1%，糖尿病为 87.7%-92.0%（HbA1c≥6.5%）或 92.7%-92.8%（HbA1c≥7%），心脏病为 85.8%-75.5%。自我报告的百分比一致性为高血压为 87.0%，糖尿病为 91.6%-92.6%，心脏病为 77.4%。
结论
与直接测量或药物使用相比，自我报告的高血压、糖尿病和心脏病史的确定是可靠和有效的。
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