老年成套神经心理测验的制定和应用

The neuropsychological test battery for elderly people

目的制定老年成套神经心理测验(NTBE)的全国T分常模。方法横断面研究,在全国15个地区内取样。调查903名60岁以上的正常老人,进行NTBE测验。应用数理分析的方法进行统计和转换,得出T分常模。另用474名正常老人的NTBE结果进行考核。并将NTBE的T分用于辅助诊断110例轻度认知功能损害(MCI)和63例阿尔茨海默病(AD)的老年患者,确定其诊断MCI和AD的敏感性和特异性。结果逐步回归分析发现,NTBE的结果受年龄、教育程度的影响显著,而受性别的影响不显著,故按年龄和文化程度进行分组。按聚类分析结果对原始变量进行合并和处理,使其符合正态分布,计算标准分数、正态性标准分数和T分转换。自身样本和考核样本考核显示NTBE内部一致性良好。NTBE诊断MCI的敏感性为66%,特异性为91%;诊断AD的敏感性为79%,特异性为96%。结论按照年龄和文化程度进行分组的T分常模符合中国老人的实际情况。用于辅助诊断MCI和AD时敏感性和特异性良好。

Objective To establish a Chinese T-score norm of neuropsychological test battery for the elderly （NTBE）. Methods 903 normal elderly people over 60 years old from Shanghai, Beijing, Hebei, Jiangsu, Hubei, Hunan, Zhejiang, Shandong and Liaoning were evaluated by using NTBE which includes tests of auditory verbal learning, sorting, cancellation, language, motor, visual function, construction, trail making 1 and 2, etc. Results Age and education greatly affected the score of NTBE, but gender did not. Based on these facts, the 903 normal subjects were divided into 12 subgroups, according to the age and the years of education they had received. The raw scores of NTBE were transformed to standard score and normalized standard score, and then these scores were transformed to a total T score （ Mean = 100, SD = 10）. Using another normal elderly sample （ n = 474 ） to analysis, the correlation between the raw scores and the total T score was significant. Using NTBE to diagnose 110 mild cognitive impairment （MCI） and 63 Alzheimer＇s disease （AD）patients, the sensitivity and specificity were 66% and 91% for MCI, and 79% and 96% for AD. Conclusion The T norm of the NTBE is suitable for Chinese elderly, and can be a useful instrument for diagnosing mild cognitive impairment and Alzheimer＇s disease.