中国认知正常成年人数字化认知常模制定的全国多中心临床研究  

The normative data of digital cognitive tests among cognitively normal Chinese adults:a national multi-center clinical research

作　　者：张丁丁 张江霞 苏宁[1] 徐运 汪凯[4] 许予明[5] 李震中[6] 胡波[7] 王丽华[8] 吴波[9] 楚兰 汪银洲[11] 江泓[12] 陆正齐[13] 武剑 范向民 韩菲[1] 姚明[1] 周立新[1] 倪俊[1] 田丰[1] 袁晶[1] 朱以诚[1] Zhang Dingding;Zhang Jiangxia;Su Ning;Xu Yun;Wang Kai;Xu Yuming;Li Zhenzhong;Hu Bo;Wang Lihua;Wu Bo;Chu Lan;Wang Yinzhou;Jiang Hong;Lu Zhengqi;Wu Jian;Fan Xiangmin;Han Fei;Yao Ming;Zhou Lixin;Ni Jun;Tian Feng;Yuan Jing;Zhu Yicheng(Department of Neurology,Peking Union Medical College Hospital,PUMC&CAMS,Beijing 100730,China;Medical Research Center,Peking Union Medical College Hospital,PUMC&CAMS,Beijing 100730,China;Department of Neurology,Nanjing Drum Tower Hospital,Nanjing 210008,China;Department of Neurology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Neurology,the Second Hospitla of Hebei Medical University,Shijiazhuang 050004,China;Department of Neurology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Neurology,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China;Department of Neurology,West China Hospital of Sichuan University,Chengdu 610044,China;Department of Neurology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China;Department of Neurology,Fujian Province Hospital,Fuzhou 350001,China;Department of Neurology,Xiangya Hospital of Central South University,Changsha 410008,China;Department of Neurology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Neurology,Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University,Beijing 102218,China;The CARE Technology Co.,Ltd,Beijing 100088,China;Institute of Software,Chinese Academy of Sciences,Beijing 100190,China)

机构地区：[1]中国医学科学院北京协和医院神经科,北京100730 [2]中国医学科学院北京协和医院医学科学研究中心,北京100730 [3]南京鼓楼医院神经内科,南京210008 [4]安徽医科大学第一附属医院神经内科,合肥230022 [5]郑州大学第一附属医院神经内科,郑州450052 [6]河北医科大学第二医院神经内科,石家庄050004 [7]武汉协和医院神经内科,武汉430022 [8]哈尔滨医科大学附属第二医院神经内科,哈尔滨150086 [9]四川大学华西医院神经内科,成都610044 [10]贵州医科大学附属医院神经内科,贵州550004 [11]福建省立医院神经内科,福州350001 [12]中南大学湘雅医院神经内科,长沙410008 [13]中山大学附属第三医院神经内科,广州510630 [14]清华大学长庚医院神经内科,北京102218 [15]北京中科睿医信息科技有限公司,北京100088 [16]中国科学院软件研究所,北京100190

出　　处：《中华脑血管病杂志（电子版）》2023年第3期179-199,共21页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：中国科学院战略性先导科技专项(XDB39040300);中国医学科学院医学与健康科技创新工程项目(2021-I2M-C&T-B-012);中央高水平医院临床科研业务费(2022-PUMCH-A-025)。

摘　　要：目的制定认知正常成年人的数字化认知测验常模。方法通过在全国12个省份中的13家三级甲等医院招募认知正常成年人,使用基于人机交互技术的数字化认知功能定量评估系统评估研究对象的认知功能,使用方差分析或非参数检验比较认知功能的不同年龄、性别和教育程度(高中及以上组、初中及以下组)组间差异,通过Bland-Altman分析和组内相关系数(ICC)评价重测信度,制作认知功能平均数常模和百分位数常模。结果共有1877名研究对象纳入分析,年龄为(59.43±15.38)岁,男性873名(46.51%),高中及以上学历者867名(46.19%),简易智力状态检查量表得分为(29.03±1.35)分。数字化认知功能定量评估系统的24个检测项目,除日期定向测试外,其他23个项目的得分均随年龄增加而降低,各年龄组间差异均具有统计学意义(P均<0.05);除连线测试2和日期定向测试外,其他22个项目的得分均是高中及以上组高于初中及以下组,差异均具有统计学意义(P均<0.05);仅有短时记忆-关联记忆、空间记忆、语法推理、鉴别测试和手指敲击测试5个项目的得分男性略高于女性,延迟记忆第三部分得分男性低于女性,差异均具有统计学意义(P均<0.05),其他18个项目男女性之间差异均无统计学意义(P均>0.05)。除找不同测试外,其他23个检测项目均具有较高的重测信度(ICC均>0.5)。研究制定了认知功能平均数常模和2.5%、5.0%、25.0%、50.0%、75.0%、95.0%和97.5%的百分位数常模。结论研究制定了该数字化认知功能定量评估系统各检测项目的不同年龄、性别、教育程度的认知常模,测验具有较高的重测信度。Objective To develop the norms of digital cognitive tests for cognitively normal Chinese adults.Methods Adult participants with normal cognitive function were recruited in 13 tertiary hospitals across 12 provinces in China.A digital cognitive test system based on human-computer interaction technology was used to assess human cognitive function quantitatively.Differences in cognitive function between age,sex,and educational level groups were compared using analysis of variance or non-parametric tests,and retest reliability was evaluated using Bland-Altman analysis and calculation of intraclass correlation coefficient(ICC).And the normative data according to age,sex,and educational level was produced.Results A total of 1877 participants(mean±SD age:59.43±15.38 years;men:873(46.51%))were included in the analysis,of which 867(46.19%)had high school or above educational level.The mean±SD of the mini-mental state examination score of 29.03±1.35.The scores of the 24 tests in the digital cognitive quantitative assessment system decreased with age,except for the“time orientation”test(all P<0.05).Except for the“trail making test 2”and“time orientation”test,the scores of the other 22 tests were higher in the high school and above group than those in the middle school and below group(all P<0.05);The scores of only the short-correlation memory,spatial memory,grammatical reasoning,discrimination test,and finger tapping test scored slightly higher in men than those in women,and the third part of delayed memory scored lower in men than those in women,showing all differences statistically significant(all P<0.05).Except for“find difference”test,all other 23 other tests had high retest reliability(all ICC>0.5).The normative data of digital cognitive tests were reported.Conclusion The norms of the digital tests stratified by age,sex and educational levels were developed with high retest reliability.

关 键 词：数字技术 认知 神经心理 常模 痴呆 

分 类 号：R749.1[医药卫生—神经病学与精神病学]