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주관적 인지 저하 호소 정도의 진단적 유용성 탐색

Exploring the Diagnostic Utility of Self-reported Cognitive Complaints

이원혜|한주현|김가영|임선진|주채린|노은정
한국임상심리학회 (Korean Clinical Psychology Association)|2024.03|한국심리학회지: 임상심리 연구와 실제 (Clinical Psychology in Korea: Research and Practice)|제10권 제1호|pp. 207-230

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참고문헌

키워드

self-report신경인지장애자기보고neurocognitive disorder교육년수years of education주관적 인지 저하subjective cognitive complaint

초록

본 연구에서는 만 60세 이상의 노인과 보호자를 대상으로 임상 면담과 신경심리평가를 실시하여 인지적 정상군(Cognitive normal), 치매가 아닌 인지장애군(Cognitive impairment no dementia, CIND), 치매군(Dementia, D)으로 분류하고, 노인의 자기보고를 통한 주관적 인지 저하 호소 정도가 상기 집단들을 구분하는데 추가적인 설명력을 갖는지 살펴보고자 한다. 주관적 인지 저하 호소 정도를 측정하기 위해 Self-Reported Version of Korean Dementia Screening Questionnaire (KDSQ-SR)를 활용하였으며, 인구통계학적 변인이나 우울감과 같은 변인들이 주관적 인지 저하 호소 정도에 유의한 영향을 미칠 가능성이 있기에, 인지장애 수준과 주관적 인지 저하 호소 정도의 관계에서 연령, 성별, 교육년수, 우울감과 같은 변인들이 유의한 영향을 미치는지 상호작용 효과를 분석하였다. 그 결과, 교육년수에서 상호작용 효과가 시사되어 상기 변인을 통제 변인으로 고려하였다. 이후 로지스틱 회귀분석과 Receiver Operating Characteristic (ROC) curve 분석을 통해 Korean-Mini Mental State Examination, 2nd edition (K-MMSE-2)을 단독으로 사용하는 것에 비해 K-MMSE-2와 KDSQ-SR을 함께 고려했을 때 CIND군, D군, 혹은 CIND군 및 D군에 대한 분류 정확도가 증가하는지 살펴보았으며, 그 결과 모든 집단에서 KDSQ-SR에 대한 추가적인 설명력이 있는 것으로 나타났다. 이러한 결과는 신경인지장애에 대한 예측 변수로서 주관적 인지 저하 호소 정도를 활용하는 것이 유용할 수 있음을 시사한다.

Abstract

This study aimed to examine the diagnostic utility of self-reported cognitive complaints to distinguish patients with dementia, cognitive impairment no dementia, and cognitive normal control group. Clinical interviews and neuropsychological assessments were conducted on older adults aged 60 years or older and caregivers. To measure the level of subjective cognitive complaints, the Self-Reported Version of Korean Dementia Screening Questionnaire (KDSQ-SR) was used. Because variables such as demographic variables and depression are likely to have a significant impact on the degree of subjective cognitive complaints, the interaction effects of age, sex, years of education, and depression were analyzed in the relationship between the level of cognitive impairment and the degree of subjective cognitive complaints. As a result, an interaction effect was suggested in years of education, so the above variable was considered as a control variable. To examine the incremental validity of KDSQ-SR, logistic regression analysis and Receiver Operating Characteristic (ROC) curve analysis were conducted. As a result, compared to using Korean-Mini Mental State Examination, 2nd edition (K-MMSE-2) alone, it was found that KDSQ-SR had additional explanatory power in all groups when K-MMSE-2 and KDSQ-SR were considered together. These results suggest that it may be useful to use the degree of subjective cognitive complaints as a predictor of neurocognitive disorder.

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