CAJ | 학술논문

目的：对认知障碍初步评价表（COG-12）在阿尔茨海默病（AD）患者中的信度与效度进行评价。方法选择2013年1～12月就诊于南京医科大学附属脑科医院老年精神科的 AD患者148例为AD组，另选择社区志愿者365例为对照组，2组均接受临床痴呆量表、AD8、简易智能状态检查量表、画钟测验评估和COG-12测评。其中100例AD患者知情者在首次评定1个月内重测COG-12。结果 COG-12的克朗巴赫α系数＝0．883，重测信度＝0．883（P＜0．01）。COG-12各条目评分与总分的相关系数为0.41～0．79（P＜0.05，P＜0．01）；COG-12总分与简易智能状态检量表、画钟测验呈负相关（r＝-0．67，r＝-0．27，P＜0．01），与临床痴呆量表、AD8总分呈正相关（r＝0．80，r＝0．81，P＜0．01）。COG-12鉴别认知正常与轻度AD患者的ROC曲线下面积＝0．902，≥6分为认知损害的界限分值敏感性为90．0％，特异性为82．5％；鉴别轻度与中度AD患者的ROC曲线下面积＝0．898，敏感性为90．5％，特异性为76．7％。结论 COG-12具有良好的信度和效度，是快速识别痴呆及评估严重程度敏感而准确的筛查评估工具。
목적：대인지장애초보평개표（COG-12）재아이자해묵병（AD）환자중적신도여효도진행평개。방법선택2013년1～12월취진우남경의과대학부속뇌과의원노년정신과적 AD환자148례위AD조，령선택사구지원자365례위대조조，2조균접수림상치태량표、AD8、간역지능상태검사량표、화종측험평고화COG-12측평。기중100례AD환자지정자재수차평정1개월내중측COG-12。결과 COG-12적극랑파혁α계수＝0．883，중측신도＝0．883（P＜0．01）。COG-12각조목평분여총분적상관계수위0.41～0．79（P＜0.05，P＜0．01）；COG-12총분여간역지능상태검량표、화종측험정부상관（r＝-0．67，r＝-0．27，P＜0．01），여림상치태량표、AD8총분정정상관（r＝0．80，r＝0．81，P＜0．01）。COG-12감별인지정상여경도AD환자적ROC곡선하면적＝0．902，≥6분위인지손해적계한분치민감성위90．0％，특이성위82．5％；감별경도여중도AD환자적ROC곡선하면적＝0．898，민감성위90．5％，특이성위76．7％。결론 COG-12구유량호적신도화효도，시쾌속식별치태급평고엄중정도민감이준학적사사평고공구。
Objective To assess the validity and reliability of COG-12 in Alzheimer's disease (AD) patients .Methods One hundred and forty-eight AD patients served as an AD group and 365 vol-unteers served as a control group in this study .Patients in two groups were assessed according to the AD8 ,CDR ,MMSE ,CDT and COG-12 ,respectively .Of the 148 AD patients ,100 were reas-sessed according to the COG-12 .Results T he Cronbach alpha coefficient and retested intraclass correlation coefficient for COG-12 were 0 .883 and 0 .883 ,respectively (P<0 .01) .The correlation coefficient for each COG-12 item score and total COG-12 score was 0 .41 -0 .79 (P< 0.05 ,P<0.01) .The total COG-12 score was negatively correlated with the MMSE and CDT ,and positively correlated with the total CDR and AD8 score (r= -0 .67 ,r= -0 .27 ,P<0 .01 ;r=0 .80 ,r=0.81 , P<0 .01) .The area under the ROC curve was 0 .902 when those with normal recognition and mild AD patients were identified according to the COG-12 with a sensitivity of 90 .0% and a specificity of 82 .5% when its cutoff was ≥6 .The area under the ROC curve was 0 .898 when the mild and moderate AD patients were identified according to the COG-12 with a sensitivity of 90.5% and a specificity of 76 .7% .Conclusion COG-12 ,with a good validity and reliability ,is a sensitive and accurate tool for the rapid screen of dementia and assessment of its severity .