Bristol最新神经心理量表中文版与相关量表在评定老年痴呆应用价值的比较

发布时间：2018-02-16 05:17

  本文关键词： Bristol最新神经心理量表 蒙特利尔认知评估量表 简易精神状态检查 老年痴呆　出处：《大连医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：随着经济的飞速发展，中国乃至全球进入老龄化社会。人均寿命的延长以及生活质量提高是人们不断追求的希望。痴呆，是一种获得性、进行性、全面性的认知功能障碍，老年痴呆可以分为阿尔茨海默病(Alzheimer's Disease, AD)痴呆、血管性痴呆及二者并存的混合型痴呆，，而阿尔茨海默病(AD)是老年痴呆中最常见的类型，是以进行性学习记忆和认知功能障碍为特征，最终导致患者生活能力丧失的一种老年性神经退行性疾病，该病严重损害老年人的身心健康。已经成为继心脏病、肿瘤、脑卒中后第四位引起成人死亡的病因。近年来AD发病率逐渐增加，并且呈现年轻化趋势。AD是一种病因不明的进行性变性疾病，发病率随年龄的增高而增加。Bristol最新神经心理量表中文版(BMDC-NPTB-CR)、蒙特利尔认知评估量表(MoCA)中文版以及简易精神状态检查(MMSE)都是新近应用于临床的关于认知功能障碍筛查和评估的量表。研究显示BMDC-NPTB-CR的信度和效度较高，与MoCA和MMSE比较，其敏感性和特异性都更具优势，但由于在国内应用时间较短，各地结果报道不一。本研究旨在对BMDC-NPTB-CR、MoC和MMSE在评定老年痴呆中的应用价值做一比较，探讨BMDC-NPTB-CR对早痴呆患者的筛查效果，为痴呆患者的早发现早治疗提供参考资料。 方法：对2011年1月至2012年12月在我院老年病科神经心理学评价室接受评定者100例老年人采用BMDC-NPTB-CR、MoCA和MMSE进行测试，以MMSE为校标，分析三个量表的平行效度并比较认知水平不同的老年人的测试成绩。所有测试均由经培训的专业人员进行，同时采集病史并给予患者体检和神经系统检查。采用DSM-Ⅳ、CDR诊断标准判断痴呆、可疑痴呆和认知正常。统计学方法采用SPSS for windows13.0软件包，多组均数比较采用方差分析，相关分析采用Pearson相关分析。 结果：Bristol最新神经心理量表的Cronbach α系数等于0.784，分量表α系数介于0.773~0.825；将各分测验量表分与量表总分进行相关性分析，相关系数r值介于0.473~0.899（P＜0.001），表明BMDC-NPTB-CR量表的内部一致性良好；MDC-NPTB-CR总分和MoCA总分分别与MMSE总分高度相关(r分别为0.787和0.897，P＜0.05)，各分测验量表具有显著的相关性，表明MDC-NPTB-CR的校标效度较好；不同认知水平的受试者，在量表测验中表现有显著差异，表明BMDC-NPTB-CR各分测验和量表总分可区分受试者的不同认知水平。 结论：Bristol最新神经心理量表中文版是信度、效度较好的标准化成套量表，可区分受试者的不同认知水平，在测定痴呆方面相比于MMSE与MocA更能对临床诊断做出早期准确有效的判断，能对老年痴呆及老年痴呆前期多项认知功能进行全面、系统评价，适合我国临床和科研工作应用。
[Abstract]:Objective: with the rapid development of economy, China and even the whole world have entered an aging society. The prolongation of life expectancy and the improvement of quality of life are the hope that people are constantly pursuing. Dementia is a kind of acquired and progressive disease. Alzheimer's disease can be divided into Alzheimer's disease (AD) dementia, vascular dementia (AD) and a mixture of the two. Alzheimer's disease (AD) is the most common type of Alzheimer's disease. It is a kind of senile neurodegenerative disease characterized by progressive learning, memory and cognitive dysfunction, which ultimately leads to the loss of patients' ability to live. The disease seriously damages the physical and mental health of the elderly. It has become a follow-up to heart disease and cancer. The incidence of AD increased gradually in recent years, and showed a trend of younger age. AD is a progressive degeneration disease of unknown etiology. The incidence rate increases with age. Bristol latest Neuropsychological scale Chinese version BMDC-NPTB-CRP, Montreal Cognitive Assessment scale MoCA Chinese version and simple Mental status Test MMSE are all newly used in clinical screening for cognitive impairment. The study showed that BMDC-NPTB-CR had higher reliability and validity. Compared with MoCA and MMSE, the sensitivity and specificity of BMDC-NPTB-CRMoC and MMSE were compared. To investigate the screening effect of BMDC-NPTB-CR in patients with Alzheimer's disease and to provide reference materials for early detection and treatment of dementia patients. Methods: from January 2011 to December 2012, 100 elderly patients who were assessed in neuropsychological evaluation department of geriatric department were tested with BMDC-NPTB-CRMoCA and MMSE. MMSE was used as standard. The parallel validity of the three scales was analyzed and the scores of the elderly with different cognitive levels were compared. All the tests were conducted by trained professionals. At the same time, the history of the disease was collected, and the patients were given physical examination and nervous system examination. The diagnostic criteria of DSM- 鈪

本文编号：1514747