An empirical evaluation of the Global Deterioration Scale for staging Alzheimer's disease.
An empirical evaluation of the Global Deterioration Scale for staging Alzheimer's disease.
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对阿尔茨海默病分期的全球恶化量表的实证评估。
DOI：
10.1176/ajp.149.2.190
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Semla,TP
中科院分区：
文献类型：
--
作者：
Eisdorfer,C;Cohen,D;Paveza,GJ;Ashford,JW;Luchins,DJ;Gorelick,PB;Hirschman,RS;Freels,SA;Levy,PS;Semla,TP
虽然自1982年出版以来，全球恶化量表已被广泛使用，但其阶段是基于对阿尔茨海默病中认知，功能和行为障碍的线性，时间性和相互依赖性的隐含假设。作者评估了这些假设的有效性和测试的假设，即精神病理学和功能障碍会发生在早期阶段比全球恶化量表predicted.MethodThe分析的基础上的数据324例阿尔茨海默氏病患者谁是从注册ofsuch患者。数据分析包括1）描述性统计的频率ofpsychiatric症状和日常生活活动的困难和2）逻辑回归，症状和功能障碍作为自变量，以测试的显着变化，在患者的状态阶段之间的全球恶化scale.Results50%以上的患者在第2阶段显示精神病理学，和32%有两个或两个以上的症状。精神症状的显着增加发生在第3和第4阶段之间，而不是在第5和第6阶段之间，正如全球恶化量表所预测的那样。各期患者的功能状态均有不同程度的损害，其中3 ~ 4期和5 ~ 6期患者的精神症状和功能损害明显增加。结论精神症状和功能损害的发生早于总体恶化量表的预测值，其变化率也不同于量表的预测值。描述认知、临床和功能状态的单独量表可能是描述疾病的最佳方式，直到开发出更好的多维工具。
ObjectiveAlthough the Global Deterioration Scale has been widely used since its publication in 1982, its stages are based on implicit assumptions about the linearity, temporality, and interdependence of cognitive, functional, and behavioral impairment in Alzheimer’s disease. The authors evaluated the validity of these assumptions and tested the hypothesis that psychopathology and functional impairment would occur in earlier stages than the Global Deterioration Scale predicts.MethodThe analyses were based on data on 324 patients with Alzheimer’s disease who were selected from a registry ofsuch patients. Data analyses included 1) descriptive statistics on the frequency ofpsychiatric symptoms and difficulties with activities of daily living and 2) logistic regression, with symptoms and functional impairment as independent variables, to testforsignificant changes in patients’ status between stages ofthe Global Deterioration Scale.ResultsMore than 50% of the patients at stage 2 displayed psychopathology, and 32% had two or more symptoms. The significant increase in psychiatric symptoms occurred between stages 3 and 4, not between stages 5 and 6 as predicted by the Global Deterioration Scale. Impairment in functionalstatus was observed at allstages, and significant increases occurred between stages 3 and 4 as well as between stages 5 and 6.ConclusionsPsychiatric symptoms and functional impairment occur earlier than predicted by the Global Deterioration Scale, and the rate of change is also different from that specified in the scale. Separate scales to describe cognitive, clinical, and functional status may be the best way to describe the illness until better multidimensional instruments are developed.