日常生活功能量表评定阿尔茨海默病患者日常生活功能的信度与效度及其应用

Reliability and validity of activity of daily living scale in Alzheimer's disease patient

目的探讨ADL在评定阿尔茨海默病患者日常生活功能中的应用。方法173例阿尔茨海默病(AD)患者应用ADL进行基线期评定,脱落16例。83例在进行为期16周盐酸美金刚治疗后进行第二次评定。74例未治疗者在4周后重复评定。逐步回归分析影响ADL分值相关因素,比较治疗组患者治疗前后ADL分值的。结果逐步回归分析显示MMSE总分、年龄和性别影响ADL总分。中度AD患者在盐酸美金刚治疗16周后ADL总分及IADL分减少。两次不同测定各单项分之间ICC值为0.84～0.96,分半信度为0.91。结论ADL总分受MMSE总分、年龄和性别的影响,盐酸美金刚能够一定程度改善中度AD患者的日常生活功能。ADL具有较好的信度。

Objective： To investigate application of activity of daily living scale （ADL） in Alzheimer＇s disease （AD）. Methods： One hundred and seventy -three patients with AD were evaluated using ADL at baseline. Sixteen patients lost to follow up. Seventy - four un-treated patients were re-evaluated after 4 weeks. Eighty -three patients were re-evaluated after treatment of memantine for 16 weeks. Related factors that impact on ADL scores were analysed using step - wise regression. ADL scores of patients in treatment group before and after treatment were compared. Results： Step- wise regression analysis showed that there was statistically significant impact of MMSE scores, age and gender on ADL total score. The range of intraclass correlation coefficient of the fourteen items with total score of the scale was 0.84 -0.96. Split - half coefficient was 0.91. Conclusion：ADL total score was affected by MMSE scores, age and gender. Memantine can improve activity of daily living of patient with AD. ADL is a reliable measure for assessing activities of daily living in patient with Alzheimer＇s disease.