국민건강보험공단 일반 검진 설문지에 포함된 인지기능 선별문항(KDSQ‐P)의 유용성
Validation of KDSQ-P as Selecting Elderly for KDSQ-C
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초록
연구배경: 2007년부터 시행된 생애전환기 건강검진에서 66세 건강진단(일반) 문진표에 인지기능 선별문항 (KDSQ-P)이 포함되어 사용되기 시작하였고, 이 문항에서 10점 만점 중 4점 이상이면, 한국판 치매 선별 설문검사(KDSQ-C) 대상자로 분류하였다. 본 연구는 KDSQ-P에 대한 유용성을 알아보기 위해 KDSQ-C 검사와의 상관관계를 보고자 하였다. 방법: 2007년 9월 1일부터 10월 7일까지 서울 일개병원 가정의학과와 강릉 일개병원 건강검진센터를 방문한 60세 이상의 환자와 보호자 및 서울 지역주민 164명을 대상으로 설문지를 자가 기입하도록 한 후 회수하여 분석하였다. 결과: 대상자는 총 164명으로 남성이 60명, 여성이 104명이었으며, 평균 나이는 71.2±7.7세였다. KDSQ-P의 기준점을 3점으로 했을 때 민감도와 특이도는 각각 87.3%, 73.3%이었으며, 4점으로 했을 때, 민감도와 특이도는 73.0%, 81.2%이었다. KDSQ-P와 KDSQ-C의 총점과의 Pearson 상관 계수는 0.741로 강한 상관관계를 보였다(P<0.01). 결론: 현재 사용되고 있는 기준점인 4점을 기준으로 했을 때 민감도가 낮아 선별검사 대상자 선정을 위한 도구로 활용하기에는 부적합한 면이 있으나, 치매 선별검사 후의 불필요한 걱정과 낙인찍기 등의 부작용을 고려했을 때, 현재 사용하고 있는 4점을 그대로 사용하는 것이 적절하다고 생각한다.
Abstract
Background: Since April 2007, the Korean Ministry for Health, Welfare, and Family Affairs has been performed a general health screening on 40 and 66 years old people who are facing their middle and old ages. The checkup list for 66 years old has been included KDSQ-P which consists of the 5 questions for detecting a person who needs KDSQ-C, screening tests for dementia. The purpose of this study is to investigate the validity of KDSQ-P. Methods: From September 1 to October 7, 2007, total 164 elderly subjects were selected and an inclusion criterion was only applied to the age over sixty. We select subjects who visited general health screening centers of Gangneung Asan hospital and the department of family medicine of Asan Medical Center and who are people in the community. All subjects answered both KDSQ-P and KDSQ-C by self-report. For the validation of the KDSQ-P, KDSQ-C was used as a gold standard. Results: The positive rates of the KDSQ-P were 50.0%, 39.6% for the cut-off point 3, 4 respectively. The positive rate of the KDSQ-C was 38.4%. The cut-off point 3, 4 for the KDSQ-P produced sensitivities of 87.3%, 73.0% and specificities of 73.3%, 81.2% respectively. Conclusions: The cut-off point 4 which was chosen by the Korean Ministry for Health, Welfare, and Family Affairs has low sensitivity. But considering side-effect of screening for dementia, the score 4 is suitable as the best cut-off points for detecting a person who needs a screening tests for dementia.
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