简版社区痴呆筛查量表（CSI-D）在湖北社区老年人中的应用研究

发布时间：2018-02-22 08:38

本文关键词： CSI-D 痴呆筛查知情人采访认知测试　出处：《华中科技大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：探讨简版社区痴呆筛查量表(The brief Community Screening Instrumentfor Dementia，CSI-D)在中国社区痴呆筛查中的可行性，分析简版CSI-D在湖北社区老年人中使用的信度和效度及整体性能。方法：对来自湖北黄石地区养老院和社区共297名老人同时进行简版CSI-D、MMSE评定，以精神疾病诊断与统计手册DSM-IV作为很可能痴呆的诊断标准，建立痴呆组、非痴呆组，非痴呆组按教育程度又分为高教育组和低教育组。分别比较简版CSI-D三类评分（认知评分、知情人评分、综合函数评分）、MMSE得分的灵敏度和特异度，用ROC曲线评估简版CSI-D的整体性能以及约登指数分析最佳临界点。结果：简版CSI-D中7个认知项目（Cronbach系数是0.753）和6个知情人项目（Cronbach系数是0.761）具有较好的内部一致性。简版CSI-D三类总分得分与MMSE得分经Spearman相关性检验显示显著相关，，r系数分别为0.903、0.784和0.876。痴呆组和非痴呆组在三类评分中均有显著性差异(p0.001)，高教育组与低教育组在认知评分上有显著性差异(p0.01)，而在知情人评分和综合函数评分没有显著性差异(p0.05)。认知评分、知情人评分和综合函数评分的灵敏度分别为90.70%、79.07%、95.35%；特异度分别为88.58%、93.31%、85.83%；AUROC分别为0.944、0.905、0.969；最佳临界点分别为4.5、1.5、4.5。结论：简版CSI-D是一个有效的、可靠的和教育文化独立的老年痴呆筛查工具，并且在疾病早期阶段有较好的灵敏度。适合非专科卫生工作者在初级卫生保健机构中使用。
[Abstract]:Objective: to explore the feasibility of the brief Community Screening Instrumentfor Dementia CSI-D in the screening of dementia in Chinese community, and to analyze the reliability, validity and overall performance of the simplified version of CSI-D in the elderly in Hubei community. Methods: a total of 297 elderly people from the nursing home and community in Huangshi area of Hubei province were assessed by CSI-DX MMSE. The DSM-IV was used as the diagnostic standard of dementia. The dementia group and non-dementia group were established. The non-dementia group was divided into high education group and low education group according to their education level. The sensitivity and specificity of the three types of scores (cognitive score, insiders score, comprehensive function score and MMSE score) were compared. The ROC curve is used to evaluate the overall performance of the simplified version of CSI-D and the optimal critical point is analyzed by Jordan index. Results: the Cronbach coefficient of 7 cognitive items in simplified CSI-D was 0.753) and the Cronbach coefficient of 6 insiders was 0.761.The results showed that there was a significant correlation between the three types of CSI-D total score and MMSE score by Spearman correlation test. The coefficients were 0.903 卤0.784 and 0.876 respectively. There was significant difference between dementia group and non-dementia group in three kinds of scores (p0.001g). There was significant difference in cognitive score between high education group and low education group (p 0.01), but there was no significant difference in informant score and comprehensive function score between high education group and low education group. Sex difference: p0.05. Cognitive score, The sensitivity of the insiders score and the comprehensive function score were 90.70 and 79.07, respectively, and the specificity was 88.58 and 93.31, respectively. The AUROC was 0.940.9050.9050.969and the optimum critical point was 4.51.54.5. Conclusion: the simplified version of CSI-D is an effective, reliable and educational and cultural independent screening tool for Alzheimer's disease, and has good sensitivity in the early stage of the disease. It is suitable for the use of non-specialized health workers in primary health care institutions.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.1

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