非语言性认知功能评估量表的验证

Validation of the Non-Language-Based Cognitive Assessment

目的编制适用于失语患者认知功能评估的非语言性神经心理测验量表（Non-Language-Based Cognlitive Assessment，NLCA）并进行信度和效度检验。方法73例正常受试者和30例轻度认知损害患者均接受NLCA和简易智能状态检查量表（Mini-Mental State Examination，MMSE）评估。从正常受试者样本中随机选gx40例完成NLCA重测以及听觉词语学习测验、Rey-Osterrieth复杂图形测验（甲式）、Stroop色词干扰测验、瑞文标准推理测验A部分以及WAIS数字广度测验。结果NLCA的内部一致性良好（Cronbach α系数为0．836，评分者间复测相关性为0．895～0．953，2～6周后复测相关性为0．863～0．952）。受教育年限与NLCA评分显著相关（r=0．852，P〈0．01）。以蒙特利尔认知评估量表为诊断标准时，接受者操作特征曲线下面积为0．899（95％可信区间0．827～0．972）。选取70分为诊断截断值时，NLCA识别轻度认知损害患者的敏感性、特异性、阳性预测值和阴性预测值均较高。结论NLCA具有良好的信度和效度，是一种符合神经心理测验基本要求的有效认知功能评估方法。

Objective To develop the Non-Language-Based Cognitive Assessment （NLCA） appficable to patients with aphasia and to validate the reliability and vafidity of NLCA. Methods Seventy-three normal subjects and 32 patients with mild cognitive impairment were evaluated by the NLCA and the Mini-Mental State Examination. Forty subjects were randomly selected from the normal subject samples were assessed with the NLCA, the Auditory Verbal Learning Test, the Rey-Osterrieth Complex Figure Test （Form A）, the Stroop Color-Word Interference Test, the Raven＇s Standard Progressive Matrices （Part A）, and the WAIS Digit Span Test. Results The NLCA had high inter-rater agreement （Cronbach＇s α coefficient 0. 836）, reliability among the assessors 0. 895 - 0. 953, test-retest reliability 0. 863 - 0. 952 at at a 2-6 week interval. The years of education was significantly correlated with NLCA （r = 0. 852, r 〈 0. 01）. When the Montreal Cognitive Assessment was used as diagnostic criteria, the area under the receiver operating characteristic curve was 0. 899 （95% confidence interval 0. 827 - 0. 972）. When cutoff at 70, the NLCA had had high sensitivity, specificity, positive predictive value and negative predictive value in the identification of patients with mild cognitive impairment. Conclusions The NLCA has good reliability and validity. It is an effective cognitive function assessment that meets the basic requirements of the neuropsychological tests.