치매선별용설문지 SIRQD 개발 D.Y. Lee, et al - 연구방법 대상자및정보제공자의선정 연구대상자 정보제공자 210

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1 KISEP Original Article J Korean Neuropsychiatr Assoc Vol 43, No 2 치매선별용정보제공자보고형설문지 Seoul Informant Report Questionnaire for Dementia (SIRQD) 의개발 서울대학교의과대학정신과학교실, 1 분당서울대학교병원신경정신과, 2 경기도립노인전문병원신경정신과, 3 분당제생병원신경정신과, 4 강원대학교의과대학정신과학교실 5 이동영 1 김기웅 2 윤종철 3 주진형 4 이정희 5 우종인 1 Development of an Informant Report Questionnaire for Dementia Screening: Seoul Informant Report Questionnaire for DementiaSIRQD Dong Young Lee, MD 1, Ki Woong Kim, MD 2, Jong Chul Yoon, MD 3, Jin Hyung Jhoo, MD 4, Jung Hie Lee, MD 5 and Jong Inn Woo, MD 1 Department of Psychiatry, 1 College of Medicine, Seoul National University, Seoul Department of Neuropsychiatry, 2 Seoul National University Bundang Hospital, Seongnam Department of Neuropsychiatry, 3 Kyunggi Provincial Hospital for the Elderly, Yongin Department of Neuropsychiatry, 4 Daejin Medical Center, Seongnam Department of Psychiatry, 5 College of Medicine, Kangwon National University, Chunchon, Korea Objectives:This study aimed to develop an informant report questionnaire for dementia screening and to verify its reliability and validity. Methods:A preliminary questionnaire with 30 items was administered to a reliable informant for each of 81 dementia patients and 166 normal controls. Through item analyses, the 15-item Seoul Informant Report Questionnaire for Dementia SIRQD was clraum up. Internal consistency and inter-informant correlation were analyzed. Factor analysis and ROC curve analysis were also performed. Results:SIRQD was found to have high internal consistency and inter-informant reliability. Optimal cut-off score of SIRQD was 9/10, and the sensitivity and specificity at that score were.850 and.873, respectively. SIRQD was composed of four major factors remote memory, recent memory, language, and activity of daily living. SIRQD was closely equivalent to MMSE-KC in terms of overall dementia screening ability, and it appeared efficient in discriminating very mild dementia from normal. SIRQD showed low false positive and negative rates, irrespective of levels of education, age, and sex Conclusion:SIRQD possess good psychometrical properties and is probably very useful to screen dementia, especially for the Korean elderly with a very wide range of educational background. (J Korean Neuropsychiatr Assoc 2004;43(2): ) KEY WORDS:Dementia Screening Questionnaire Informant SIRQD. 서 론 - 209

2 치매선별용설문지 SIRQD 개발 D.Y. Lee, et al - 연구방법 대상자및정보제공자의선정 연구대상자 정보제공자 210

3 D.Y. Lee, et al 치매선별용설문지 SIRQD 개발 설문지제작및신뢰도와타당도검증설문지제작 Table Items included in the preliminary questionnaire ,, , 10.,, 11., , 17.,, 18.,, 19.,, , ,, 25., 26.,, ,,

4 치매선별용설문지 SIRQD 개발 D.Y. Lee, et al 신뢰도검증 타당도검증 - SIRQD와 MMSE-KC 비교치매선별력비교 인구학적변인의영향비교 212

5 D.Y. Lee, et al 치매선별용설문지 SIRQD 개발 통계분석 연구결과 대상자및정보제공자의특성 Table 2. Characteristics of the subjects and informants Subjects Control Dementia Number Age yr Education yr Sex Male Female Informants Types of informant Spouse Child Other family member Others Living with informant Yes No Contact frequency with informant* day/week Only for individuals not living with an informant MeanS.D., Number percent SIRQD의신뢰도와타당도 신뢰도 타당도 213

6 치매선별용설문지 SIRQD 개발 D.Y. Lee, et al Table 3. Sensitivity, specificity, positive predictive value and negative predictive value of SIRQD for the screening of dementia patients n=247 Cut-off Sensitivity Specificity 4/ / / / / / / / / / / AUCArea under the curve, Bold Characters indicate optimal cut-off score determined by ROC curve analysis Table 4. Factor loading for five factors in a factor analysis of SIRQD n=247 Item Factor 1 Factor 2 Factor 3 Factor Percentage of variance explained Cummulative percentage of variance explained NoteFactor loadings greater than.39 were presented with bold characters for easy interpretation. SIRQD와 MMSE-KC 비교 치매선별력 Table 5. False positive and false negative value for optimum cutoff score* of SIRQD and MMSE-KC according to education, age, and sex Demographic False postive False negative variable SIRQD MMSE-KC SIRQD MMSE-KC Education yr Age (yr) < Sex Male Female /10 for SIRQD, 21/22 for MMSE-KC 인구학적변인의영향 고 찰 214

7 D.Y. Lee, et al 치매선별용설문지 SIRQD 개발 - 215

8 치매선별용설문지 SIRQD 개발 D.Y. Lee, et al 결론 중심단어 REFERENCES 1) Lezak MD. Neuropsychological assessment. New York, Oxford University Press;1995. p ) 이동영, 이강욱, 이정희, 김기웅, 주진형, 윤종철등. Mini-Mental State Examination 의한국노인정상규준연구. 신경정신의학 2002; 41: ) Malloy PF, Cummings JL, Coffey CE, Duffy J, Fink M, Lauterbach EC, et al. Cognitive Screening Instruments in neuropsychiatry: A report of the committee on research of the American Neuropsychiatric Association. J Neuropsychiatr Clin Neurosci 1997;9: ) 통계청. 인구통계연감. 서울 : 통계청 ; ) Jorm AF. Methods of screening for dementia: A meta-analysis of studies comparing an informant questionnaire with a brief cognitive test. Alzheimer s Dis Assoc Dis 1997;11: ) Ritchie K, Fuhrer R. A comparative study of the performance of screening tests for senile dementia using Receiver Operating Characteristics analysis. J Clin Epidemiol 1992;45: ) Jorm AF, Korten AE. Assessment of cognitive decline in the elderly by informant interview. Br J Psychiatry 1988;152: ) Jorm AF. A short form of the Informant Questionnaire on cognitive decline in the elderly IQCODE: development and cross-validation. Psychol Med 1994;24: ) Lee JH, Lee KU, Lee DY, Kim KW, Jhoo JH, Lee KH, et al. Development of the Korean version of the Consortium to Establish a Registry for Alzheimer s Disease CERAD Assessment Packet CERAD-K: Clinical and Neuropsychological Assessment Batteries. J Gerontol B Psychol Sci 2002;57: ) American Psychiatric Association. Diagnostic and Statistical Manual of Mental disorders, 4th edition. Washington DC, American Psychiatric Association; ) McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical Diagnosis of Alzheimers Disease: Report of the NI- NCDS-ADRDA Work Group under the auspices of the Department of Health and Human Service Task Force on Alzheimers Disease. Neurology 1984;34: ) Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, et al. Vascular dementia: diagnostic criteria for research studies. Reprot of the NINDS-AIREN International Workshop. Neurology 1993;43: ) Hughes CP, Berg L, Danziger WL, Cohen LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry 1982;140: ) Metz CE. Basic principles of ROC analysis. Semin Nucl Med 1978; 8: , 15) Hanley JA, McNeil BJ. The meaning and use of the area under a Receiver Operating Characteristic ROC curve. Radiology 1982;143: ) Masur DM, Sliwinski M, Lipton RB, Blau AD, Crystal HA. Neuropsychological prediction of dementia and the absence of dementia in healthy elderly persons. Neurology 1994;44: ) Häninen T, Hallikainen M, Koivisto K, Helkala E-L, Reinikainen KJ, Soininen H, et al. A follow-up study of age-associated memory impairment: Neuropsychological predictors of dementia. J Am Geriatr Soc 1995;43: ) Jacobs DM, Sano M, Dooneief G, Marder K, Bell KL, Stern Y. Neu- 216

9 D.Y. Lee, et al 치매선별용설문지 SIRQD 개발 ropsychological detection and characterization of preclinical Alzheimer s disease. Neurology 1995;45: ) Howieson DB, Dame A, Camicioli R, Sexton G, Payami H, Kaye JA. Cognitive markers preceding Alzheimer s dementia in the healthy oldest old. Am J Geraitr Soc 1997:45: ) Koss E, Patterson MB, Ownby R, Stuckey JC, Whitehouse PJ. Memory evaluation in Alzheimer s disease: Caregivers appraisals and objective testing. Arch Neurol 1993;50: ) McGlone J, Gupta S, Humphrey D, Oppenheimer S, Mirsen T, Evans DR. Screening for early dementia using memory complaints from patients and relatives. Arch Neurol 1990;47: ) Carr DB, Gray S, Baty J, Morris JC. The value of informant vs. individul s complaints of memory impairment in early dementia. Neurology 2000;55: ) World Health Organization. the ICD-10 classification of mental and behavioral disorders. Clinical descriptions and diagnostic guidelines. Geneva, World Health Oragnization; ) Jorm AF, Scott R, Cullen JS, MacKinnon AJ. Performance of the informant questionnaire on cognitive decline in the elderly IQCODE as a screening test for dementia. Psychol Med 1991;21: ) Kawas C, Segal J, Stewart WF, Corrada M, Thal LJ. A validation study of the Dementia Questionnaire. Arch Neurol 1994;51: ) 최성혜, 나덕렬, 강연욱, 이원용, 박병주. Samsung Dementia Questionnaire 의타당도와신뢰도평가. 대한신경과학회지 1998;16: ) 탁진국. 심리검사 : 개발과평가방법의이해. 서울, 학지사 ;1996. p ) Barclay LL, Zemcov A, Blass JP, McDowell FH. Factors associated with duration of survival in Alzheimer s disease. Biol Psychiatry. 1985;20: ) Diesfeldt HFA, Van Houte LR, Moerkens RM. Duration of survival in senile dementia. Acta Psychiatr Scand 1986;73:

10 치매선별용설문지 SIRQD 개발 D.Y. Lee, et al 부 록 SIRQD(Seoul Informant Report Questionnaire for Dementia) , ,, , ,, , ,, , 최종점수 10

J Korean Neurol Assoc / Volume 21 / August, 2003 The Validity and Reliability of the Korean Modified Mini-Mental State (K-3MS) Examination Eun-Hee Soh

J Korean Neurol Assoc / Volume 21 / August, 2003 The Validity and Reliability of the Korean Modified Mini-Mental State (K-3MS) Examination Eun-Hee Sohn, Ae-Young Lee, Hyun-Ju Park* Department of Neurology