The reliability and validity of Chinese version of AD8

目的 检验《AD8》中文译本在Alzheimer病(AD)患者中应用的信度与效度;初步确定《AD8》中文译本区分AD患者与认知正常老人界限分值及敏感度和特异度.方法 共入组240例受试者,正常对照75例,AD患者165例.正常对照和AD患者接受临床痴呆量表(CDR)、简易精神状态检查(MMSE)、画钟测验(CDT)评估.向所有正常对照及AD患者知情者询问《AD8》中文译本.其中158例AD患者知情者在1个月内重测《AD8》.结果 (1)《AD8》中文译本的克朗巴赫系数α=0.78,重测信度(ICC)=0.96(P＜0.01).(2)各条目评分间相关系数为0.36～0.69(P＜0.01);《AD8》中文译本总分与CDR总体评分(r=0.82,P＜0.01)和各领域评分总和(r=0.80,P＜0.01)呈正相关,与MMSE(r=-0.75,P＜0.01)和CDT得分(r=-0.53,P＜0.01)呈负相关.(3)《AD8》鉴别认知正常者与AD患者的AUC=0.93,以≥2为认知损害的界限分值,敏感度为93.9％,特异度为76.0％.结论 《AD8》中文译本具有良好的信度和效度,是识别早期痴呆的一项简单敏感的筛查工具.Objective To examine the validity and reliability of the application of Chinese version of AD8 among patients with Alzheimer's disease (AD),and to explore the discriminative properties of AD8 including score boundaries,sensitivity and specificity in differentiating AD and normal controls.Methods A total of 240 subjects were recruited,including 75 cognitively intact subjects as normal control and 165patients with AD.Normal control and patients with AD were assessed with Clinical Dementia Rating (CDR),Mini-Mental State Examination (MMSE),and Clock Drawing Test (CDT).All informed normal controls and informants of patients with AD were asked about Chinese version of AD8,among which,158informants of patients with AD received AD8 examination again.Results (1) The Cronbach alpha for Chinese version of AD8 was 0.78.The intraclass correlation coefficient (ICC) of retest reliability was 0.96(P ＜ 0.01).(2) The correlation coefficients between each item of AD8 ranged from 0.36 to 0.69(P＜ 0.01).Chinese version of AD8 total scores were strongly positively correlated with CDR global score (r =0.82,P ＜ 0.01),and CDR-SB(r =0.80,P ＜ 0.01),and negatively correlated with the total score of MMSE (r =-0.75,P ＜0.01)and CDT(r =-0.53,P ＜0.01).(3) For discrimination between normal controls and patients with AD,the AUC was 0.93.Using a cutoff of 2 or greater on Chinese version of AD8 to discriminate dementia,the sensitivity was 93.9％,and specificity was 76.0％.Conclusion Chinese version of AD8 is a brief and sensitive screening measure with good validity and reliability.国家自然科学基金; 科技部863计划; 美国国立老龄研究所与Fogarty国际中心合作基金项目; 北京大学精神卫生研究所青年基金项目PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)010777-7805