哈佛自动电话任务:早期阿尔茨海默病日常生活测试的新表现为基础的活动。

IF 8.5 3区 医学 Q1 CLINICAL NEUROLOGY Jpad-Journal of Prevention of Alzheimers Disease Pub Date : 2015-12-01 DOI:10.14283/JPAD.2015.72
G. Marshall, M. Dekhtyar, Jonathan Bruno, K. Jethwani, R. Amariglio, Keith A. Johnson, R. Sperling, D. Rentz
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引用次数: 16

摘要

日常生活活动障碍是阿尔茨海默病患者和护理人员的主要负担。多种主观量表和一些基于表现的工具已被证实并证明在测量阿尔茨海默病痴呆患者的日常生活工具活动方面是可靠的,但在健忘轻度认知障碍和临床前阿尔茨海默病中则不太可靠。目的验证哈佛自动电话任务,这是一项针对早期阿尔茨海默病的新的基于表现的日常生活活动测试,该测试评估老年人在日常生活中挑战的高水平任务。在一项横断面研究中,通过单变量和多变量分析,哈佛自动电话任务与人口统计学和认知测量相关联;评估了不同诊断组的区分能力;在一部分参与者中评估了相同版本和替代版本的重测信度;在一部分参与者中评估了与区域皮层厚度的关系。学术型临床研究中心。参与者从社区(127名临床正常老年人和45名年轻正常参与者)和布里格姆妇女医院和马萨诸塞州总医院的记忆障碍诊所(10名轻度认知障碍参与者)招募了182名参与者。测量作为哈佛自动电话任务的一部分,参与者通过交互式语音应答系统重新填写处方(APT-Script),选择新的初级保健医生(APT-PCP),并进行银行账户转账和付款(APT-Bank)。这3个任务是根据时间、错误和重复来评分的,综合z分数从中得出,以及正确完成任务的单独报告。结果我们发现哈佛自动电话任务在诊断组之间有很好的区分(APT-Script: p=0.002;APT-PCP: p < 0.001;APT-Bank: p=0.02),具有递增难度,具有优异的重测信度(Cronbach’s α值为0.81 ~ 0.87)。在临床正常的老年人中,在多变量模型中,哈佛自动电话任务的表现与执行功能(APT-PCP: p<0.001)、处理速度(APT-Script: p=0.005)和区域皮质萎缩(APT-PCP: p=0.001;与APT-Script无显著相关性),与听力敏锐度、运动速度、年龄、种族、教育程度和病前智力无关。我们对哈佛自动电话任务的初步经验表明,这些任务可以用于筛选和跟踪临床前和早期前驱AD的早期功能改变,该任务包括生态有效、易于管理的日常活动测量。
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The Harvard Automated Phone Task: new performance-based activities of daily living tests for early Alzheimer's disease.
BACKGROUND Impairment in activities of daily living is a major burden for Alzheimer's disease dementia patients and caregivers. Multiple subjective scales and a few performance-based instruments have been validated and proven to be reliable in measuring instrumental activities of daily living in Alzheimer's disease dementia but less so in amnestic mild cognitive impairment and preclinical Alzheimer's disease. OBJECTIVE To validate the Harvard Automated Phone Task, a new performance-based activities of daily living test for early Alzheimer's disease, which assesses high level tasks that challenge seniors in daily life. DESIGN In a cross-sectional study, the Harvard Automated Phone Task was associated with demographics and cognitive measures through univariate and multivariate analyses; ability to discriminate across diagnostic groups was assessed; test-retest reliability with the same and alternate versions was assessed in a subset of participants; and the relationship with regional cortical thickness was assessed in a subset of participants. SETTING Academic clinical research center. PARTICIPANTS One hundred and eighty two participants were recruited from the community (127 clinically normal elderly and 45 young normal participants) and memory disorders clinics at Brigham and Women's Hospital and Massachusetts General Hospital (10 participants with mild cognitive impairment). MEASUREMENTS As part of the Harvard Automated Phone Task, participants navigated an interactive voice response system to refill a prescription (APT-Script), select a new primary care physician (APT-PCP), and make a bank account transfer and payment (APT-Bank). The 3 tasks were scored based on time, errors, and repetitions from which composite z-scores were derived, as well as a separate report of correct completion of the task. RESULTS We found that the Harvard Automated Phone Task discriminated well between diagnostic groups (APT-Script: p=0.002; APT-PCP: p<0.001; APT-Bank: p=0.02), had an incremental level of difficulty, and had excellent test-retest reliability (Cronbach's α values of 0.81 to 0.87). Within the clinically normal elderly, there were significant associations in multivariate models between performance on the Harvard Automated Phone Task and executive function (APT-PCP: p<0.001), processing speed (APT-Script: p=0.005), and regional cortical atrophy (APT-PCP: p=0.001; no significant association with APT-Script) independent of hearing acuity, motor speed, age, race, education, and premorbid intelligence. CONCLUSIONS Our initial experience with the Harvard Automated Phone Task, which consists of ecologically valid, easily-administered measures of daily activities, suggests that these tasks could be useful for screening and tracking the earliest functional alterations in preclinical and early prodromal AD.
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来源期刊
自引率
7.80%
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期刊介绍: The JPAD « Journal of Prevention of Alzheimer’Disease » will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including : neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes. JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.
期刊最新文献
Burden of Illness in People with Alzheimer's Disease: A Systematic Review of Epidemiology, Comorbidities and Mortality. Are Population-Level Approaches to Dementia Risk Reduction Under-Researched? A Rapid Review of the Dementia Prevention Literature. Expectancy Does Not Predict 18-month Treatment Outcomes with Cognitive Training in Mild Cognitive Impairment. Lifestyle and Socioeconomic Transition and Health Consequences of Alzheimer's Disease and Other Dementias in Global, from 1990 to 2019. Data-Driven Thresholding Statistically Biases ATN Profiling across Cohort Datasets.
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