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Journal of the Korean Academy of Family Medicine 2000;21(7):876-883.
Published online July 1, 2000.
The relationship between the Alzheimer's Disease Assessment Scale and other measures of dementia.
Young Dong Kim, Kyung Chae Park, Young Gon Kang, HO Taek Lee, Seok Ki Lee, Young Jin Lee, Chul Young Bae
1Department of Family Medicine, Pundang CHA General Hospital, Koera.
2Department of Family Medicine, College of Medicine, Pochon Chungmoon University, Korea.
Alzheimer's Disease Assessment Scale 과 MMSE-K 및 기타 노인기능 평가도구들 간의 상관관계
이석기, 이호택, 김영동, 박경채, 강영곤, 이영진, 배철영
1
2
Abstract
Background
: The cognitive subscale of the Alzheimer's Disease Assessment Scale(ADAS-Cog) has been extensively validated in assessing cognitive function in patients with Alzheimer's Disease (AD) and used as an efficacy measure in clinical trials of AD. There is a need for additional data on the relationship between cognitive performance and other measures of dementia to fully assess the value of the ADAS-Cog as a measure of treatment efficacy.

Methods : We used data from 53 AD participants in 8 multicenter clinical drug trials to examine the distribution of baseline ADAS-Cog scores in relation to Mini-Mental State Examination (MMSE), Global Deterioration Scale (GDES), Katz Index of Activity of Daily Living(ADL), Lawton Instrumental Activity of Daily Living(IADL), Geriatric Depression Scale(GDS) and Mini-Nutritional Assessment(MNA).

Results : The ADAS-Cog score was statistically significantly correlated with MMSE (T=-0.755, P<0.001), GDES(R=0.403, P<0.003), ADL(R=-0.532, P<0.001), IADL(R=-0.626, P<0.001) and MNA(R=-0.427, P=0.004) scores. But GDS scores were not associated with ADAS-Cog scores.(R= -0.123, P=0.396)

Conclusion : This study characterizes the relationship between ADAS-Cog scores and other commonly used measures of dementia in AD patients. As expected, baseline scores on ADAS-Cog and MMSE demonstrated significantly high correlation. The relatively weaker correlation between ADAS-Cog and GDES scores may be related to the fact that GDES does not evaluate cognitive function only. There are also significant correlations between ADAS-Cog and ADL, IADL, and MNA which indicate the severity and progression of dementia in AD patients. Further studies with larger samples including cognitive function of broader spectrum need to confirm the findings in this study.
초록
연구배경 : Alzheimer's Disease Assessment Scale (ADAS-Cog)은 알쯔하이머형 치매의 심한 정도와 특징적인 인지기능 평가를 위한 표준 평가도구로 인정받고 있다. 아직 국내에는 알쯔하이머형 치매시 사용하는 다른 치매평가도구들과 ADAS-Cog와의 상관관계에 대한 연구가 부족하다.

방법 : 다기관 임상 약물실험 연구에 참가한 53명의 알쯔하이머형 치매환자의 기초조사 자료를 이용하여 ADAS-Cog 점수와 Mini-Mental State Examination(MMSE-K), Global Deterioration Scale (GDES), Katz Index of Activity of Daily Living(ADL), Lawton Instrumental Activity of Daily Living(IADL), Geriatric Depression Scale(GDS) 그리고 Mini-Nutritional Assessment(MNA) 점수간의 상관관계를 알아보았다.

결과 : 53명의 대상자에서 ADAS-Cog 평균점수(± 표준편차)는 32.9 ± 14.1 이었고 MMSE 점수는 15.7 ± 5.1 이었다. ADAS-Cog 점수와 MMSE(R=-0.755, P<0.001), GDES(R=0.403, P<0.003), ADL(R=-0.532, P<0.001), IADL(R=-0.626, P<0.001) 그리고 MNA(R=-0.427, P=0.004) 점수 간에는 통계적으로 유의한 상관관계를 보였다. 그러나 GDS는 ADAS-Cog와 유의한 관련을 보이지 않았다(R= -0.123, P=0.396).

결론 : 알쯔하이머형 치매환자의 평가도구로서 ADAS-Cog, MMSE, GDES는 서로 유사한 연관성을 지니며, 환자의 신체적 기능 소실과 영양 상태는 치매의 심한 정도와 어느 정도 관련이 되어 있으나, 우울 증상은 이와 무관할 수 있음을 보여준다. 연구의 제한점으로 대상이 적었고 이들이 치매 인구를 대표하지 않는다는 점이며, 향후 연구에서는 많은 환자를 대상으로 다른 변수들의 관련이 다루어져야 할 것이다.


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