Gaining precision on the Alzheimer's Disease Assessment Scale-cognitive: A comparison of item response theory-based scores and total scores
Gaining precision on the Alzheimer's Disease Assessment Scale-cognitive: A comparison of item response theory-based scores and total scores
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DOI：
10.1016/j.jalz.2011.05.2409
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发表时间：
2012-07-01
影响因子：
14
通讯作者：
Doody, Rachelle S.
中科院分区：
文献类型：
--
作者：
Balsis, Steve;Unger, Alexis A.;Doody, Rachelle S.
背景资料：阿尔茨海默病评估量表-认知（ADAS-cog）是用于评估阿尔茨海默病（AD）患者认知功能障碍的常用指标。该测量有11个分量表，每个分量表都捕获了AD认知功能障碍的一个重要方面。ADAS-cog的传统评分包括将各分量表的评分相加，而不考虑其难度或与AD相关认知功能障碍的关系强度。本文分析了与这种方法相关的问题，并提供了解决方案，获得测量精度通过建模如何子量表function.Methods：我们分析了收集的数据在贝勒医学院阿尔茨海默氏病和记忆障碍诊所从1240例诊断为不同程度的痴呆症。项目反应理论被用来确定ADAS-cog上的总分和所反映的认知功能障碍的潜在水平之间的关系的scores.Results：结果显示，每个总分对应的认知功能障碍的频谱，表明总分是相对不精确的指标潜在的认知功能障碍。此外，它是常见的两个人具有相同的总得分有显着不同程度的认知功能障碍。结论：这些研究结果表明，项目反应理论评分的ADAS-cog可以更精确地测量认知功能障碍比总得分的方法。(C)2012年，阿尔茨海默氏症协会。All rights reserved.
Background: The Alzheimer's Disease Assessment Scale-cognitive (ADAS-cog) is a commonly used measure for assessing cognitive dysfunction in patients with Alzheimer's disease (AD). The measure has 11 subscales, each of which captures an important aspect of cognitive dysfunction in AD. Traditional scoring of the ADAS-cog involves adding up the scores from the subscales without regarding their varying difficulty or their strength of relationship to AD-associated cognitive dysfunction. The present article analyzes problems associated with this approach and offers solutions for gaining measurement precision by modeling how the subscales function.Methods: We analyzed data collected at the Baylor College of Medicine Alzheimer's Disease and Memory Disorders Clinic from 1240 patients diagnosed with varying degrees of dementia. Item response theory was used to determine the relationship between total scores on the ADAS-cog and the underlying level of cognitive dysfunction reflected by the scores.Results: Results revealed that each total score corresponded to a spectrum of cognitive dysfunction, indicating that total scores were relatively imprecise indicators of underlying cognitive dysfunction. Furthermore, it was common for two individuals with the same total score to have significantly different degrees of cognitive dysfunction.Conclusions: These findings suggest that item response theory scoring of the ADAS-cog may measure cognitive dysfunction more precisely than a total score method. (C) 2012 The Alzheimer's Association. All rights reserved.