Cognitive screening assessment in Thai older adults: a prospective study of the reliability and validity of the Abbreviated Mental Test.
Cognitive screening assessment in Thai older adults: a prospective study of the reliability and validity of the Abbreviated Mental Test.
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泰国老年人的认知筛查评估：对缩写心理测试的可靠性和有效性的前瞻性研究。
DOI：
10.1108/jhr-02-2020-0049
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发表时间：
2022-01-13
影响因子：
1.7
通讯作者：
中科院分区：
文献类型：
--
作者：
本文的目的是检验简略心理测验（AMT）的信度和效度及其与简易精神状态测验（MMSE）的一致性。这项横断面研究包括446名老年人，他们是通过整群抽样从200,481名60岁以上的成年人中招募的。对于每个参与者，AMT由村卫生志愿者管理，并在另外一天由训练有素的专业人员管理，该专业人员也管理MMSE。采用描述性统计、Bland和Altman一致性水平和接受者算子曲线（roc）对数据进行分析。在年度健康筛查期间，由村卫生志愿者进行的AMT管理发现，只有1.12%的样本存在认知障碍。当由训练有素的专业人员给这些人进行AMT治疗时，认知障碍的发生率几乎高出24倍。泰国AMT中的两个项目可能需要修改，因为故障率明显升高。cut评分为8分时，AMT相对于MMSE的敏感性和特异性均为中等，分别为78.83和66.67%。AMT与MMSE之间的一致性程度为0.49 (p < 0.001)，差异评分与平均值之间的相关性异常低（0.048）。可靠和有效的认知筛查评估要求管理人员受过良好的培训，并且工具适合人群。虽然AMT简短且易于非专业人员管理，但由于结构效度和上下文问题，有些项目不适合。
The purpose of this paper is to examine the reliability and validity of the Abbreviated Mental Test (AMT) and the agreement with the Mini-Mental State Examination (MMSE). This cross-sectional study included 446 older adults who were recruited by cluster sampling from 200,481 adults aged more than 60 years. For each participant, the AMT was administered by village health volunteers and, on a separate day, by a trained professional who also administered the MMSE. Descriptive statistics, Bland and Altman levels of agreement, and Receiver Operator Curves (ROCs) were used to analyze data. Administration of the AMT by village health volunteers during the annual health screening found cognitive impairment in only 1.12% of the sample. When the AMT was given to these same individuals by trained professionals, the rate of cognitive impairment was almost 24 times greater. Two items in the Thai AMT may require modification due to markedly elevated failure rates. At the cut score of 8, the sensitivity and specificity of the AMT relative to the MMSE were moderate (78.83 and 66.67%, respectively). The degree of agreement between AMT and MMSE was 0.49 (p < 0.001) and the correlation between the difference scores and the mean is exceptionally low (0.048). Reliable and valid cognitive screening assessment requires the administrator to be well trained and the tools to be appropriate for the population. Although AMT is short and easy for a nonprofessional to administer, some items were not suitable due to construct validity and contextual issues.
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