Auer S R, Sclan S G, Yaffee R A, Reisberg B
Aging and Dementia Research Center, New York University Medical Center, NY 10016.
J Am Geriatr Soc. 1994 Dec;42(12):1266-72. doi: 10.1111/j.1532-5415.1994.tb06509.x.
Traditional mental status and psychometric assessments bottom out in the late stages of Alzheimer disease (AD). A method adapted from cognitive testing in infants, the Ordinal Scales of Psychological Development was modified (M-OSPD) and applied to a severely demented population. The concurrent validity of this method was tested in comparison with Functional Assessment Staging (FAST). Internal consistency as a measure for reliability was also determined.
Cross sectional study.
Subjects were generally evaluated in their residence, usually a nursing home or a private home.
Severely cognitively impaired subjects who fulfilled criteria for probable AD were studied.
Evaluation consisted of clinical global, mental status, functional, and cognitive assessments including the Global Deterioration Scale (GDS) and the Mini-Mental State Examination (MMSE).
Seventy patients were evaluated. Traditional mental status assessments (eg, the MMSE) manifested virtually uniform bottom scores in all GDS stage 7 subjects (n = 46), and GDS stage 6 subjects had MMSE scores within one standard deviation unit of zero. In contrast, the M-OSPD scale continued to show results in the last stages of the disease. The Spearman correlation coefficient between the M-OSPD total score and the 11 FAST substages represented in this sample was -0.77 (P < 0.001).
The results indicate that patients who are functionally more impaired also show continuing increments in cognitive loss. These cognitive and functional assessments for measuring the magnitude of deterioration in AD can be applied to the estimated half-million nursing home residents presently labeled "untestable" with the goal of optimization of care and residual capacities.
传统的精神状态和心理测量评估在阿尔茨海默病（AD）晚期会出现评分下限。一种源自婴儿认知测试的方法，即改良版心理发展顺序量表（M-OSPD），被应用于重度痴呆人群。该方法与功能评估分期（FAST）相比，对其同时效度进行了测试。还确定了作为可靠性指标的内部一致性。
横断面研究。
受试者一般在其住所接受评估，通常是养老院或私人住宅。
研究符合可能AD标准的重度认知受损受试者。
评估包括临床总体、精神状态、功能和认知评估，包括总体衰退量表（GDS）和简易精神状态检查表（MMSE）。
对70名患者进行了评估。在所有GDS 7期受试者（n = 46）中，传统的精神状态评估（如MMSE）几乎呈现统一的低分，而GDS 6期受试者的MMSE分数在零的一个标准差单位范围内。相比之下，M-OSPD量表在疾病的最后阶段仍能显示出结果。本样本中M-OSPD总分与11个FAST子阶段之间的斯皮尔曼相关系数为-0.77（P < 0.001）。
结果表明，功能受损更严重的患者在认知丧失方面也持续增加。这些用于测量AD病情恶化程度的认知和功能评估可应用于目前被标记为“无法测试”的估计50万养老院居民，以优化护理和残余能力。
