改良临床痴呆评定量表中文版信效度的初步研究  

Reliability and validity of the Chinese edition of modified clinical dementia rating scale without informant version： a preliminary study

作　　者：孙芸[1,2] 靳士立[2] 谢贞[2] 张勇辉[3] 刘晓华[3] 李美娟[3] 张宝华[4] 孔永彪 杨建立[1] 

机构地区：[1]天津医科大学精神医学教研室,天津300022 [2]天津市安定医院精神科,天津300022 [3]山东省安康医院精神科 [4]天津市公安局安康医院

出　　处：《中华行为医学与脑科学杂志》2015年第2期178-180,共3页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的 评价临床痴呆评定量表的改良版-无知情人信息版（CDR-NI）用于中国社区老年人认知功能障碍评估的信效度.方法 经过培训的精神科护士对90例伴有认知功能下降主诉的社区老年人进行CDR-NI评定;同时老年精神科医师对对象及其亲属进行访谈以诊断认知功能障碍,并完成简易智能精神状态检查量表（MMSE）评定;30例对象两周后接受了CDR-NI的复测.结果 ①信度：CDR-NI内部一致性克朗巴赫α系数为0.84,不同评定者间量表总评分加权Kappa值为0.90,量表总评分两周重测Kappa值为0.81.②效度：CDR-NI原始分与MMSE总分相关系数为-0.75 （P＜ 0.01）,CDR-NI分级的无认知障碍、轻度认知功能障碍和轻度痴呆患者的MMSE评分分别为（27.6±2.9）分、（23.4±3.0）分和（20.1±3.8）分,差异具有统计学意义（F=13.72,P=0.007）.CDR-NI分级与临床诊断的一致性加权Kappa值为0.87.结论 CDR-NI中文译本具有较好的信度和效度,能够在没有知情人提供信息的情况下有效评估社区中伴有认知功能下降主诉的老人的认知功能状况.Objective To determine the reliability and validity of the Chinese edition of modified clinical dementia rating scale without informant version （CDR-NI） for the assessment of cognitive impairment of Chinese community elderly.Methods Trained psychiatric nurses administered CDR-NI to 90 community-dwelling older adults,who had the complaints of cognitive decline; meanwhile,geriatric psychiatrists interviewed the elderly and their informants to give diagnoses of cognitive disorders and completed the Mini Mental State Examination （MMSE）.Thirty subjects received a re-test of CDR-NI two weeks later.Results ①Reliability：the internal consistency of CDR-NI,Cronbach＇ sα coefficient,was 0.84.The inter-rater and two weeks＇ re-test reliability coefficients were 0.90 and 0.81,respectively.②Validity：the correlation coefficient between CDR-NI and MMSE scores was-0.75 （P〈0.01）.According to CDR-NI staging score,MMSE scores for subjects without cognitive impairment,mild cognitive impairment and mild dementia were （27.6± 2.9）,（23.4 ± 3.0） and （19.1 ± 3.8）,respectively,the differences between the three groups were statistically significant （F=13.72,P〈0.01）.The weighted Kappa value between CDR-NI stages and clinical diagnosis was 0.87.Conclusion CDR-NI has good reliability and validity and is suitable to assess the cognitive impairment of community elderly,who had the complaints of cognitive decline and no available informants.

关 键 词：认知功能损害 改良痴呆临床评定量表 信度 效度 

分 类 号：R473.74[医药卫生—护理学]