摘要：

研究背景 AD8 自评量表对痴呆的早期诊断价值已经临床实践证实，但是由于文化背景和语言习惯差异，需编制适合国人的痴呆自查问卷，以提高痴呆早期诊断率和识别能力。方法 根据痴呆早期症状和我国老年人生活习惯，并参照AD8 自评量表编制新的痴呆自查问卷（共10 项内容），对陕西省西安市8 个社区年龄≥ 50 岁长住居民进行问卷调查，验证其筛查痴呆的信度和效度，以及诊断痴呆的敏感性和特异性。结果 共620 例社区老年人完成新编痴呆自查问卷调查，筛出痴呆病例17 例（2.74%）。问卷各分项评分与总评分呈正相关（r_s = 0.300 ~ 0.709，均P = 0.000），其Cronbach α值为0.795，内部一致性信度良好。提取2 个主成分因子，累计方差贡献率为49.771%；各亚项的因子载荷均> 0.500，结构效度良好。以新编痴呆自查问卷评分2 分为临界值，其诊断痴呆的灵敏度为94.10%、特异度为82.10%、Youden 指数0.762。结论 新编痴呆自查问卷可以敏感、准确地识别痴呆，对早期筛查痴呆具有重要临床价值。

关键词: 痴呆, 问卷调查, 神经心理学测验

Abstract:

Background  The AD8 plays an important role in the early diagnosis of dementia. However, because of cultural and language difference, it is difficult for Chinese subjects to understand and answer questions in AD8. This paper aims to make a new dementia self-rating questionnaire for Chinese people based on the AD8, and to determine its value for dementia screening.  Methods  According to early symptoms of dementia and life style of old Chinese people, a dementia self-rating questionnaire was made based on the AD8. The new questionnaire includes 10 questions, and can be finished in 3 min. The reliability and validity was validated by a questionnaire survey in senior citizens older than 50 years in urban Xi'an. All patients were screened by Mini-Mental State Examination (MMSE) and dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders Forth Edition (DSM-Ⅳ) criteria.  Results  A total of 620 patients finished the new questionnaire, and among them 17 patients (2.74% ) were diagnosed as dementia. The score of each question in the questionnaire was positively correlated with the total score (r_s = 0.300-0.709; P = 0.000, for all). The Cronbach α was 0.795, indicating that the questionnaire got good internal consistency reliability. Two principal components were extracted, and the cumulative variance contribution ratio was 49.771%. Factor loading of each subitem was > 0.500, indicating a good construct validity. According to receiver operating characteristic (ROC) curve, the critical value was 2, with the sensitivity 94.10% and specificity 82.10%. Youden index was 0.762.  Conclusions  The new dementia self-rating questionnaire can detect dementia patients sensitively and correctly, and is very useful for early screening of dementia.

Key words: Dementia, Questionnaire, Neuropsychological tests