本文關(guān)鍵詞： CSI-D 癡呆 篩查 知情人采訪 認(rèn)知測(cè)試　出處：《華中科技大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討簡(jiǎn)版社區(qū)癡呆篩查量表(The brief Community Screening Instrumentfor Dementia，CSI-D)在中國(guó)社區(qū)癡呆篩查中的可行性，分析簡(jiǎn)版CSI-D在湖北社區(qū)老年人中使用的信度和效度及整體性能。 方法：對(duì)來(lái)自湖北黃石地區(qū)養(yǎng)老院和社區(qū)共297名老人同時(shí)進(jìn)行簡(jiǎn)版CSI-D、MMSE評(píng)定，以精神疾病診斷與統(tǒng)計(jì)手冊(cè)DSM-IV作為很可能癡呆的診斷標(biāo)準(zhǔn)，建立癡呆組、非癡呆組，非癡呆組按教育程度又分為高教育組和低教育組。分別比較簡(jiǎn)版CSI-D三類評(píng)分（認(rèn)知評(píng)分、知情人評(píng)分、綜合函數(shù)評(píng)分）、MMSE得分的靈敏度和特異度，用ROC曲線評(píng)估簡(jiǎn)版CSI-D的整體性能以及約登指數(shù)分析最佳臨界點(diǎn)。 結(jié)果：簡(jiǎn)版CSI-D中7個(gè)認(rèn)知項(xiàng)目（Cronbach系數(shù)是0.753）和6個(gè)知情人項(xiàng)目（Cronbach系數(shù)是0.761）具有較好的內(nèi)部一致性。簡(jiǎn)版CSI-D三類總分得分與MMSE得分經(jīng)Spearman相關(guān)性檢驗(yàn)顯示顯著相關(guān)，，r系數(shù)分別為0.903、0.784和0.876。癡呆組和非癡呆組在三類評(píng)分中均有顯著性差異(p0.001)，高教育組與低教育組在認(rèn)知評(píng)分上有顯著性差異(p0.01)，而在知情人評(píng)分和綜合函數(shù)評(píng)分沒(méi)有顯著性差異(p0.05)。認(rèn)知評(píng)分、知情人評(píng)分和綜合函數(shù)評(píng)分的靈敏度分別為90.70%、79.07%、95.35%；特異度分別為88.58%、93.31%、85.83%；AUROC分別為0.944、0.905、0.969；最佳臨界點(diǎn)分別為4.5、1.5、4.5。 結(jié)論：簡(jiǎn)版CSI-D是一個(gè)有效的、可靠的和教育文化獨(dú)立的老年癡呆篩查工具，并且在疾病早期階段有較好的靈敏度。適合非專科衛(wèi)生工作者在初級(jí)衛(wèi)生保健機(jī)構(gòu)中使用。
[Abstract]:Objective: to explore the feasibility of the brief Community Screening Instrumentfor Dementia CSI-D in the screening of dementia in Chinese community, and to analyze the reliability, validity and overall performance of the simplified version of CSI-D in the elderly in Hubei community. Methods: a total of 297 elderly people from the nursing home and community in Huangshi area of Hubei province were assessed by CSI-DX MMSE. The DSM-IV was used as the diagnostic standard of dementia. The dementia group and non-dementia group were established. The non-dementia group was divided into high education group and low education group according to their education level. The sensitivity and specificity of the three types of scores (cognitive score, insiders score, comprehensive function score and MMSE score) were compared. The ROC curve is used to evaluate the overall performance of the simplified version of CSI-D and the optimal critical point is analyzed by Jordan index. Results: the Cronbach coefficient of 7 cognitive items in simplified CSI-D was 0.753) and the Cronbach coefficient of 6 insiders was 0.761.The results showed that there was a significant correlation between the three types of CSI-D total score and MMSE score by Spearman correlation test. The coefficients were 0.903 鹵0.784 and 0.876 respectively. There was significant difference between dementia group and non-dementia group in three kinds of scores (p0.001g). There was significant difference in cognitive score between high education group and low education group (p 0.01), but there was no significant difference in informant score and comprehensive function score between high education group and low education group. Sex difference: p0.05. Cognitive score, The sensitivity of the insiders score and the comprehensive function score were 90.70 and 79.07, respectively, and the specificity was 88.58 and 93.31, respectively. The AUROC was 0.940.9050.9050.969and the optimum critical point was 4.51.54.5. Conclusion: the simplified version of CSI-D is an effective, reliable and educational and cultural independent screening tool for Alzheimer's disease, and has good sensitivity in the early stage of the disease. It is suitable for the use of non-specialized health workers in primary health care institutions.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R749.1

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