運用於老人認知刺激之整體性認知測量工具

The Global Cognitive Measures in Elderly for Cognitive Stimulation

本文的目的在介紹除MMSE 外，6 種運用於認知刺激介入的老人整體性認知測量工具，如：阿茲海默症評估量表-認知（Alzheimer's Disease Assessment Scale-Cognitive, ADAS-Cog）、劍橋老人心智障礙檢測-認知（Cambridge Mental disorders of the elderly examination-cognitive examination, CAMCOG）、認知功能障礙篩檢量表（Cognitive Assessment Screening Instrument, CASI）、阿茲海默症聯合登錄研究組織之神經心理測驗（Consortium to Establish a Registry for Alzheimer's Disease, CERAD）、蒙特利爾認知評估（Montreal Cognitive Assessment, MoCA）、重複系列性神經心理狀態評估（Repeatable Battery for the Assessment of Neuropsychological Status, RBANS），並介紹工具的發展、測量面向、計分方式、信效度與優缺點等，雖然此6 個工具皆具有穩定的心理計量特性（psychometric properties），但對不同的認知功能缺損狀態卻有不同程度的區辨效度。因此建議未來在選用工具時，研究者除考量工具的表現與優缺點外，同時還應依循研究的目的以及研究對象的特質，選用合乎研究設計的工具。

The aim of this article was to introduce six global measures of cognition, which have been applying in clinical trials for the elderly, including Alzheimer's Disease Assessment Scale-Cognitive/ADAS-Cog; Cambridge Mental disorders of the elderly examination-cognitive examination/CAMCOG; Cognitive Assessment Screening Instrument/CASI; Consortium to Establish a Registry for Alzheimer's Disease/CERAD; Montreal cognitive assessment/ MoCA; Repeatable Battery for the Assessment of Neuropsychological Status/ RBANS. The authors described these instruments individually on different dimensions including instrument development, measurements of domains, scoring, reliability, validity, their advantages as well as disadvantages. Although researches have shown that these 6 instruments did have good performance in psychometric properties. However, their discriminant validities of detecting the severity of cognitive deficit are different. It is recommended that, before making a choice among the instruments, researchers should consider the development, performance, advantages and disadvantages of the instruments as well as the purpose, and characteristics of the target population it will be applied to.