Discriminative power of the advanced activities of daily living (a-ADL) tool in the diagnosis of mild cognitive impairment in an older population
Discriminative power of the advanced activities of daily living (a-ADL) tool in the diagnosis of mild cognitive impairment in an older population
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DOI：
10.1017/s1041610215000563
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发表时间：
2015-09-01
影响因子：
7
通讯作者：
Gorus, E.
中科院分区：
文献类型：
--
作者：
De Vriendt, P.;Mets, T.;Gorus, E.
背景资料：轻度认知功能障碍（MCI）的特征是在没有明显功能下降的情况下的主观和客观记忆障碍。日常生活活动（ADL）的轻度变化可能存在，并可能预测转化为痴呆症。开发了一种新的高级（a）-ADL工具，评估高水平活动，并将每个参与者作为自己的参考，根据所进行的活动数量以及功能问题的严重程度和原因，区分全球残疾指数（a-ADL-DI）、认知残疾指数（a-ADL-CDI）和身体残疾指数（a-ADL-PDI）。本研究评价了a-ADL在MCI中的区分效度。方法：根据临床评估和一组整体、认知、情绪和功能评估，对150名社区参与者进行了问卷调查。（平均年龄80.3岁（SD 5; 66-91））被包括并被诊断为（1）认知健康的参与者（n = 50）;（2）a-MCI患者（n = 48）或（3）轻至中度AD患者（n = 52）。结果：a-ADL-DI和a-ADL-CDI的敏感性和特异性为70%~ 94.2%，阳性预测值为70%~ 93.8%，阴性预测值为64.4%~ 93.8%，曲线下面积（AUC）为0.791 ~ 0.960。与身体缺陷相关的功能下降，评估的a-ADL-PDI，并没有区分不同groups.Conclusion：a-ADL工具有一个很好的能力来区分正常和病理性认知老化。它对限制的根本原因的辨别力可能是一个优势。
Background: Mild cognitive impairment (MCI) is characterized by subjective and objective memory impairments in the absence of manifest functional decline. Mild changes in activities of daily living (ADL) can be present and probably predict conversion to dementia. A new advanced (a)-ADL tool was developed, evaluating high-level activities and, taking each participant as their own reference, distinguishing a global Disability Index (a-ADL-DI), a Cognitive Disability Index (a-ADL-CDI), and a Physical Disability Index (a-ADL-PDI), based on the number of activities performed and the severity and causes of the functional problem. This study evaluates the discriminative validity of the a-ADL in MCI.Method: Based upon clinical evaluation and a set of global, cognitive, mood, and functional assessments, 150 community-dwelling participants (average age 80.3 years (SD 5; 66-91)) were included and diagnosed as (1) cognitively healthy participants (n = 50); (2) patients with a-MCI (n = 48), or (3) mild to moderate AD (n = 52). The a-ADL tool was not a part of the clinical evaluation.Results: The a-ADL-DI and the a-ADL-CDI showed a sensitivity and specificity ranging from 70% to 94.2%, Positive Predictive Value ranging from 70% till 93.8%, and Negative Predictive Value from 64.4% and 93.8%, an area under the curve (AUC) ranging from 0.791 to 0.960. Functional decline related to physical deficits, as assessed by the a-ADL-PDI, did not discriminate between the different groups.Conclusion: The a-ADL tool has a good ability to distinguish normal and pathological cognitive aging. Its discriminative power for underlying causes of limitations may be an advantage.