- 期刊
Cut-Off Values of Blessed Dementia Rating Scale and Its Clinical Application in Elderly Taiwanese
布雷斯氏失智量表在台灣老年族群的應用
摘要
布雷斯氏失智量表(BDRS)在臨床上雖然被廣泛的應用，然而在考量輕度認知功能障礙下，有關其判斷值和臨床應用卻是較少被提出的。因此在我們的研究中，在隨機抽樣下選取南台灣65歲以上的老年人口，施測布雷斯氏失智量表(BDRS)、簡易智能狀態檢查(MMSE)、臨床失智量表(CDR)並持續追蹤兩年，將所有第一年的研究對象、以及第二、三年的失智症(CDR≥1)和輕度認知功能障礙者(CDR=0.5)納入統計分析，而使總統計人數達到3,027人。在區分正常和輕度認知功能障礙時，除在此65-74歲有受教育組外，MMSE比BDRS有較高的鑑別力。且此時BDRS的判斷值在65-74歲和大於75歲受教育組皆為1；在65-74歲和大於75歲較低教育者分別為1.5和2；BDRS在區分輕度認知功能障礙和失智症的鑑別力，都有比MMSE較好的結果。且此時BDRS的判斷值在65-74歲和大於75歲受教育組皆為2.5；在65-74歲和大於75歲較低教育者分別為2.5和3。在未來老年化的人口中，65-74歲受教育組勢必會增加，BDRS應該可以被當作一個比MMSE有效率的篩檢工具，來篩檢輕度認知功能障礙和失智症。
並列摘要
Although the Blessed Dementia Rating Scale (BDRS), a clinical screening instrument, has been applied extensively, no suitable cut-off values and clinical application have been proposed, particularly in mild cognitive impairment (MCI), the precursor of dementia. The BDRS, Mini Mental State Examination (MMSE), and Clinical Dementia Rating Scale (CDR) were administrated in people aged 65 years and above, who were enrolled from southern Taiwan with multistep stratified random sampling and followed-up for 2 years. All subjects (total number = 3,027), with new onset of MCI (defined as CDR = 0.5) in the first year and dementia (defined as CDR≥1) in the second and third years were subjected to statistical analysis. In distinguishing normal from MCI, except in the literate group aged 65-74 years, MMSE was superior to BDRS, with cut-off values of 1 in both literate groups aged 65-74 years and ≥75 years, and 1.5 and 2 in less educated groups aged 65-74 and ≥75 years, respectively. In distinguishing MCI from dementia, BDRS had cut-off values of 2.5 in both literate groups aged 65-74 and ≥75 years, and 2.5 and 3 in less educated groups aged 65-74 and ≥75 years, respectively. These values were better than those for MMSE in all groups. BDRS might be considered as a better tool than MMSE to screen for MCI and dementia in the increasing proportion of literate elderly aged 65-74 years in the aging population.