Bellelli G, Frisoni G B, Bianchetti A, Trabucchi M
Geriatric Research Group, Sacro Cuore Fatebenefratelli Hospital, Brescia, Italy.
Alzheimer Dis Assoc Disord. 1997 Jun;11(2):71-7. doi: 10.1097/00002093-199706000-00003.
We evaluated the floor effect and convergent, discriminant, and known-group validity of the Bedford Alzheimer Nursing Severity scale (BANS-s), a rating scale comprising cognitive and functional items recently developed for grading severe dementia. Ninety-nine demented patients (81 females and 18 males aged 55-100 years) in two nursing homes were assessed with the BANS-s, established cognitive and functional scales [Mini Mental State Examination, the extended version of the Clinical Dementia Rating (CDR), Katz's basic activities of daily living, Tinetti balance and gait, and Crichton scales], a behavioral scale (UCLA Neuropsychiatric Inventory), and indicators of malnutrition (Prognostic Nutritional Index). A relevant proportion (40%) of patients scored close to the floor of all scales except BANS-s and CDR, which showed a more uniform distribution of scores throughout the possible range. Convergent validity of BANS-s with the other cognitive and functional scales was good, with Pearson's r ranging from 0.62 to 0.79. Discriminant validity analysis of BANS-s versus the UCLA Neuropsychiatric Inventory showed that the two scales measure different domains (Pearson's r = 0.36). To test known-group validity, all patients were divided into two groups of different severity as defined by the Prognostic Nutritional Index. BANS-s and CDR were the scales with the best ability to discriminate malnourished from nonmalnourished patients. As a further validity test, the 37 patients reaching the floor on other cognitive and functional scales were divided into two subgroups of different dementia severity as defined by the Tinetti scale. BANS-s but not CDR was able to differentiate the two groups.
我们评估了贝德福德老年痴呆护理严重程度量表（BANS-s）的地板效应、聚合效度、区分效度和已知群体效度。BANS-s是一种评分量表，包含认知和功能项目，最近开发用于对重度痴呆进行分级。对两家疗养院的99名痴呆患者（81名女性和18名男性，年龄55 - 100岁）进行了BANS-s评估，同时还使用了既定的认知和功能量表[简易精神状态检查表、临床痴呆评定量表（CDR）扩展版、卡茨日常生活基本活动量表、蒂内蒂平衡和步态量表以及克里顿量表]、行为量表（加州大学洛杉矶分校神经精神科问卷）和营养不良指标（预后营养指数）。除BANS-s和CDR外，相当比例（40%）的患者在所有量表上的得分都接近最低分，而BANS-s和CDR在整个可能得分范围内的得分分布更为均匀。BANS-s与其他认知和功能量表的聚合效度良好，皮尔逊相关系数r在0.62至0.79之间。BANS-s与加州大学洛杉矶分校神经精神科问卷的区分效度分析表明，这两个量表测量的是不同领域（皮尔逊相关系数r = 0.36）。为了检验已知群体效度，根据预后营养指数将所有患者分为两组不同严重程度的患者。BANS-s和CDR是区分营养不良患者和非营养不良患者能力最强的量表。作为进一步的效度检验，将在其他认知和功能量表上得分最低的37名患者根据蒂内蒂量表分为两组不同痴呆严重程度的亚组。BANS-s能够区分这两组患者，而CDR则不能。
