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정상, 경도인지장애와 알츠하이머형 치매환자를 대상으로 IQCODE-K, K-AD8, AQS 간의 비교연구

Comparative Study Between IQCODE-K, K-AD8, andAQS in Normal Cognition, Mild Cognitive Impairment,and Alzheimer's Type Dementia

김상윤|박정란|백민재|한유미
한국노인작업치료학회 (Korean Society for Geriatric Occupational Therapy)|2022.12|한국노인작업치료학회지 (Korea Journal of Geriatric Occupational Therapy)|제4권 제2호|pp. 63-75|DOI 10.23189/yksgot.2022.4.2.004

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키워드

Mild cognitive impairmentDementia경도인지장애알츠하이머치매보호자InformantScreening tool선별도구

초록

목적 : 본 연구의 목적은 정상, 경도인지장애, 알츠하이머치매 환자집단을 대상으로 보호자용 치매선별검사 도구인 Korean version Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-K)와 Eight-item Interview to Differentiate Aging and Dementia 한국어판(K-AD8), 그리고 Attention Questionnaire Scale (AQS)를 비교하여 임상적 유용성을 평가하는 것이다. 연구방법 : 본 연구에는 169명의 환자가 참여하였고, 대조군은 정상인 31명, 임상군은 경도인지장애(Mild Cognitive Impairment; MCI) 78명과 알츠하이머치매 환자(Alzheimer Dementia; AD) 60명이었다. 수집된 자료로 Receiver operating characteristic 곡선을 이용하였고 민감도와 특이도, Area Under the ROC Curve(AUC) 및 Clinical Utility Index(CUI)를 제시하였다. 결과 : 세 가지 도구 모두 실제 인지적으로 손상된 환자군(MCI 또는 AD)을 “보통”수준에서 검사상 인지적으로 손상이 있는 것으로 분류해낼 수 있었다. 또한 MCI와 AD군 간의 비교에서는, 세 도구 모두 실제 MCI 환자를 검사상 “보통”수준에서 MCI로 분류했으나 실제 AD 환자들을 검사상 AD로 분류해낸 도구는 IQCODE-K만이 “보통”수준으로 가능하였다. 결론 : 세 가지 도구 모두 자세한 신경심리검사 없이 단독으로 인지기능의 손상 유무를 선별할 수 있는 도구임이 재확인되었고, 특히 IQCODE-K가 알츠하이머치매 환자(AD)들의 변별에서는 다른 두 도구에 비해 상대적으로 높은 변별력을 지닌 것으로 나타났다.

Abstract

Objective : Clinical usefulness was evaluated by comparing the Informant Questionnaire on Cognitive Decline in the Elderly Korean Version (IQCODE-K), AD8 Korean Version (K-AD8), and Attention Questionnaire Scale (AQS), which are screening tools for informants in groups with normal cognition, mild cognitive impairment, and Alzheimer’s type dementia. Methods : Among the 169 patients who participated in the study, of which 31 had normal cognition in the control group, 78 had mild cognitive impairment (MCI) and 60 had Alzheimer's dementia (AD) in the clinical groups. From the data, Sensitivity, specificity, AUC, and CUI were presented by using a Receiver-operating-characteristic curves from the data. Results : All three tools were able to classify the actual cognitively impaired group as impaired at the “fair” level. In addition, on the comparison of the groups of MCI and AD patients, all three tools could classify the actual MCI group at the “fair” level as MCI in the test, but only IQCODE-K could classify actual AD patients as AD in the test. Conclusion : It was reaffirmed that all three tools can be used alone for screening for impairment of cognitive function without neuropsychological tests, and in particular, IQCODE-K was found to have relatively better discrimination ability than the other two tools in AD patients.

참고문헌 (33)

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