Royall D R, Cordes J, Polk M
Department of Psychiatry, South Texas Veterans' Healthcare System, Audie L. Murphy Division Geriatric Research Education Clinical Center, San Antonio, USA.
Exp Aging Res. 1997 Oct-Dec;23(4):301-13. doi: 10.1080/03610739708254033.
This study examined the independent contributions of executive control function, general cognition, age, education, and medication usage to the comprehension of medical information. Randomly selected elderly retirees (N = 105) more than 70 years of age completed the Executive Interview (EXIT25), the Mini-Mental State Exam (MMSE), and the Hopkins Competency Assessment Test (HCAT). Cognitive measures were stronger predictors of HCAT scores than age, education, or number of prescribed medications. A discriminant model based on EXIT25 and MMSE scores correctly classified 91% of subjects relative to their HCAT scores. It was concluded that executive impairment is strongly associated with impaired comprehension of medical information. As many as 88% of probable Alzheimer's disease patients, 69% of institutionalized elderly retirees, and 49% of noninstitutionalized retirees may be impaired in their ability to comprehend medical information, even when it has been presented well below their educational level.
本研究考察了执行控制功能、一般认知、年龄、教育程度和药物使用情况对医学信息理解的独立影响。随机选取了105名70岁以上的老年退休人员，他们完成了执行功能访谈（EXIT25）、简易精神状态检查表（MMSE）和霍普金斯能力评估测试（HCAT）。认知测量指标比年龄、教育程度或处方药数量更能有效预测HCAT分数。基于EXIT25和MMSE分数的判别模型，相对于HCAT分数，正确分类了91%的受试者。研究得出结论，执行功能障碍与医学信息理解受损密切相关。即使医学信息的呈现水平远低于他们的教育程度，多达88%的疑似阿尔茨海默病患者、69%的机构养老老年退休人员和49%的非机构养老退休人员在理解医学信息的能力上可能存在障碍。
