蒙特利尔认知评估量表在评估轻度认知损害老人中的验证性因素分析  

Confirmatory factor analysis of the Montreal Cognitive Assessment in evaluating elderly mildcognitive impairment

作　　者：董新秀 胡慧[2] 王凌[2] 艾亚婷[2] 杨重明[3] 孙凯丽 石义容[2] 李梦盈 Dong Xinxiu';Hu Hui;Wang Ling;Ai Yating;Yang Chongming;Sun Kaili;Shi Yirong;Li Mengying(Medical School,Jianghan University,Wuhan 430010,China)

机构地区：[1]江汉大学医学院,武汉430010 [2]湖北中医药大学 [3]Bfgham Young University,Provo,UT 84602,USA

出　　处：《中华神经科杂志》2018年第12期966-971,共6页Chinese Journal of Neurology

基　　金：国家自然科学基金面上项目(81473747).

摘　　要：目的评估北京版蒙特利尔认知量表评估(MoCA)在武汉市筛查轻度认知损害老年人中的可行性及其作为筛查工具的测量学属性和结构效度。方法运用MoCA对武汉市381例社区轻度认知损害老年人进行认知功能评估,分析MoCA的信度和效度,并用验证性因素分析来评估认知功能各方面与MoCA各维度之间的关系,检验北京版MoCA不同因素结构模型之间的差异性。结果北京版MoCA一个因子时(模型1)信度系数为0.76,两个因子时(模型3)的信度系数为0.71,北京版MoCA与简易精神状态检查评定结果高度相关(r=O.73,P<0.01);北京版MoCA在模型3取2个因子(F1:视空间执行功能,F2:以记忆力为主的其他认知功能)的拟合度高于模型1取1个因子,且模型1和模型3在因子个数间的差异有统计学意义(x^2dif=8.73,P<0.01)。结论北京版MoCA的验证睦因素分析表明,其实际反映两个高度相关但不同的因子,即视空间执行功能和以记忆力为主的其他认知功能;因子负荷低的指标应被对中国文化敏感的项目替换。Objective To assess the psychometric potential of the Montreal Cognitive Assessment Scale-Beijing (MoCA-BJ)as a screening instrument for mild cognitive impairment (MCI)in older adults in Wuhan communities of central China.Methods MoCA-BJ and Mini-Mental State Examination (MMSE)were adopted to assess the MCI of 381older adults from 13communities in Wuhan in 2015.Confirmatory factor analysis was conducted to evaluate the construct validity of MoCA-BJ,and the relationship between all aspects of cognitive function and MoCA different dimensions.Results MoCA-BJ had acceptable reliability (w=0.76),and MoCA-BJ and MMSE estimation results were highly correlated (r=0.73,P<0.01).By comparing three measurement models through confirmatory factor analysis,we found that the MoCA-BJ scale had two factors'(FI:visual space executive function,F2:memory-based other cognitive functions)in model 3,fit degree of which was higher than model 1by one factor,and there was a statistically significant difference in the number of factors between model 1and model 3(X^2dif=8.73,P<0.01).Conclusions The MoCA-BJ has two underlying factors that respectively represent two highly correlated but distinct factors,cognition and visualspatial.Uninformative items should be revised with culturally sensitive items and the cut-off point for mild impairment should also be altered.

关 键 词：认知障碍 因素分析 统计学 蒙特利尔认知评估量表 

分 类 号：R749.1[医药卫生—神经病学与精神病学]