三种淡漠量表在初筛为轻度认知功能障碍老年人知情者中的应用分析

A comparison of the Lille Apathy Rating Scale-informant, the Apathy Evaluation Scale-Informant, and the Neuropsychiatric Inventory-Apathy Subscale in mild cognitive impairment informants

目的 对里尔淡漠评定量表-知情者版（LARS-i）、淡漠评定量表-知情者版（AES-I）、神经精神问卷-淡漠亚量表（NPI-Apathy）在初筛为轻度认知功能障碍（MCI）老年人知情者中的应用结果进行比较分析,为淡漠表现的测评提供参考依据.方法 使用LARS-i、AES-I、NPI-Apathy对181名社区初筛为MCI老年人的家属进行调查,并采用相关性分析法、受试者工作特征曲线对比分析法对3种淡漠量表进行对比分析.结果 对于初筛为MCI的老年人,中文版量表LARS-i、AES-I分别选取-16分、33分为界值时,对应量表的敏感度、特异度较高,分别为72.00％、65.38％和75.31％、75.76％.中文版量表LARS-i得分与AES-I得分、AES-I得分与NPI-Apathy得分间存在正相关关系（r =0.566、0.388,均P＜0.01）;AES-I、NPI-Apathy得分与老年抑郁量表（GDS）得分间存在正相关关系（r =0.250、0.169,均P＜0.05）,LARS-i得分与GDS得分无相关关系;LARS-i、AES-I得分与MoCA得分呈负相关关系（r=-0.232、-0.239,均P＜0.01）,NPI-Apathy得分与MoCA得分无相关关系;量表AES-I与LARS-i测评的淡漠发生情况类似（分别为94例、81例）,多于NPI-Apathy测评所得的淡漠例数（25例）.结论 中文版量表LARS-i与AES-I在初筛为MCI老年人知情者中的应用结果类似,优于NPI-Apathy,且LARS-i对淡漠、抑郁表现有一定的区分度.

Objective To compare the Lille Apathy Rating Scale-informant （LARS-i）,the Apathy Evaluation Scale-Informant （AES-I） and the Neuropsychiatric Inventory-Apathy Subscale （NPI-Apathy） in mild cognitive impairment （MCI） informants.Methods Data were collected from 181 informants of patients with MCI by the LARS-i,AES-I and NPI-Apathy scales.The evaluation results by the three scaleswere analyzed by correlation analysis and receiver operating characteristic （ROC） curve.Results By the Chinese versions of the LARS-i and AES-I scales,the best ROC curve was at a cutoff score of-16,33 respectively for a prediction of apathy （with sensitivity of 72.00%,75.31% respectively,and specificity of 65.38%,75.76% respectively）.The scores of the LARS-i and AES-i scales （r =0.566,P 〈0.01）,and the scores of AES-I and NPI-Apathy scales （r =0.388,P 〈 0.01） were positively correlated.The AES-I and NPI-Apathy scores were positively correlated with the scores of the Geriatric Depression Scale （r =0.250,0.169,P〈0.05）,while the score of the LARS-i scale not.The scores of LARS-i,AES-I scales were negatively correlated with the score of MoCA scale （r =-0.232,-0.239,P 〈 0.01）,whereas the NPI-Apathy score had no correlation with the MoCA score.The AES-I and LARS-i scales reported greater apathy compared to that reported by the NPI-Apathy scale,with cases of 94,81,25 respectively.Conclusions The results of the Chinese versions of LARS-i and AES-I scales are similar,which are better than the NPI-Apathy scale in MCI informants in China.And the LARS-i scale can distinguish between apathy and depression to a certain extent.