Development of an UPSA Short Form for Use in Longitudinal Studies in the Early Alzheimer's Disease Spectrum
Development of an UPSA Short Form for Use in Longitudinal Studies in the Early Alzheimer's Disease Spectrum
复制标题
DOI：
10.14283/jpad.2019.51
复制
发表时间：
2020-03-01
影响因子：
6.4
通讯作者：
Gomar, Jesus J.
中科院分区：
文献类型：
--
作者：
Goldberg, T. E.;Harvey, P. D.;Gomar, Jesus J.
背景：在仅有轻度或非常轻微认知功能减退的个体中(即所谓的临床前AD)，基于表现的功能测量可能优于基于信息者的测量，因为它具有更高的灵敏度、更高的可靠性和更少的天花板效应。目的在对轻度认知障碍(MCI)和早期阿尔茨海默病(AD)患者进行为期一年的系列评估的背景下，我们试图确定基于表现的日常功能测量是否具有足够的心理测量学特性和效度。设计参与者在基线、六周和一年时用基于绩效的测量进行评估。设立阿尔茨海默病评估和治疗专业中心。研究对象包括三组受试者：健康受试者(HS)、认知正常老年人组(N=43)、MCI组(N=20)和AD组(N=26)。测量UCSD基于绩效的技能评估(UPSA)(称为UPSA-3)的三个分测试缩写形式是对兴趣的测量。它包括沟通、规划和金融子测试。结果：使用混合模型重复测量来评估随时间推移的绩效。存在大的群体效应(HS>；MCI>；AD)。此外，AD组和MCI组在一年内表现出下降，而HS组保持稳定(x组交互作用p=.11)。MCI/AD组表现出足够的重测信度，没有表现出天花板或地板效应。结论我们的数据表明，UPSA-3适合于临床试验，因为它具有足够的生态覆盖和合理的心理测量学特性，可能最重要的是，在系列评估中显示出有效性。
Background In individuals with only mild or very mild cognitive attenuations (i.e., so-called pre-clinical AD), performance-based measures of function may be superior to informant-based measures because of increased sensitivity, greater reliability, and fewer ceiling effects. Objective We sought to determine if a performance-based measure of everyday function would demonstrate adequate psychometric properties and validity in the context of serial assessment over a one-year period in patients with Mild Cognitive Impairment (MCI) and early stage Alzheimer's disease (AD). Design Participants were assessed with the performance-based measure at baseline, six weeks, and one year. Setting A specialized center for the assessment and treatment of AD. Participants Three groups of subjects participated: a healthy subjects (HS) older cognitively intact group (N=43), an MCI group (N=20), and an AD group (N=26). Measurements A three subtest short form of the UCSD Performance-Based Skills Assessment (UPSA) (called the UPSA-3) was the measure of interest. It consisted of the Communication, Planning, and Finance subtests. RESULTS: Mixed model repeated measures were used to assess performance over time. Large group effects were present (HS>MCI>AD). Additionally, the AD and MCI groups demonstrated declines over one year, while the HS group remained stable (group x time interaction p=.11). The MCI/AD group demonstrated adequate test-retest reliability and did not demonstrate ceiling or floor effects. Conclusion Our data indicate that the UPSA-3 is suitable for clinical trials in that it has adequate ecological coverage and reasonable psychometric properties, and perhaps most importantly, demonstrates validity in serial assessments.