阿尔茨海默病功能知情者印象评估量表的信效度及临床应用的初步研究

Reliability and validity of AD Informant Impression Evaluation Scale and its application in clinical treatment of AD

目的评价阿尔茨海默病(AD)功能知情者印象评估量表(AD-IE)的信效度及其在AD治疗评价中的作用。方法纳入全国255家医院门诊AD患者4392例,根据简易智能状态检查量表评分分为重度组597例、中重度组958例、轻中度组1720例和轻度组1117例,患者给予多奈哌齐治疗,由照料者根据患者近1个月综合情况完成AD-IE测查,共20个条目,评估AD-IE的内部一致性效度及结构效度,比较患者治疗前后AD-IE评分的变化。结果重度组、中重度组、轻中度组、轻度组治疗前和治疗后的AD-IE评分比较,差异均有统计学意义(P=0.00)。治疗前和治疗后AD-IE的Cronbach标准α系数分别为0.8538和0.8381,α系数均>0.8,量表内部一致性极好;结构效度分析显示,AD-IE的20个条目中,除第14条在对应因子的负荷为0.3522外,余19个条目在对应因子的负荷均>0.400;治疗后AD-IE评分较治疗前明显降低[(8.37±4.81)分vs(10.84±5.05)分,P<0.01]。结论AD-IE具有良好的信效度,能够让照料者从正面感受到药物治疗效果,适于照料者对AD干预效果进行评估。

Objective To evaluate the reliability and validity of AD-IE Scale and its role in evaluating the therapeutic effect of AD.Methods A total of 4392 AD patients from the outpatient departments of 255 hospitals were divided into severe group(n=597),moderate-severe group(n=958),mild-moderate group(n=1720),and mild group(n=1117).The patients were treated with donepezil.The internal consistency validity and structure validity of AD-IE Scale were assessed,and the AD-IE Scale scores were recorded and compared before and after treatment.Results Significant differences were detected in AD-IE Scale score among the 4 groups before and after treatment(P=0.00).The standardαcoefficient of Cronbach was 0.8538 and 0.8381 respectively before and after treatment with an excellent internal consistency.Structure validity analysis showed that the load of corresponding factor for the 19 items was>0.400 while that for the 14th item was 0.3522.The AD-IE Scale score was significantly lower after treatment than before treatment(P<0.01).Conclusion AD-IE Scale is of a good reliability and a good validity,and can thus be used by the caregivers to assess the effect of drug treatment in AD patients.