臺灣北部地區正常中老年人簡短式高級大腦皮質功能檢查量表常模研究

Abstract

簡短式高級大腦皮質功能檢查量表為一針對臺灣地區低教育程度中老年族群設計之神經心理測驗組合，內容包含定向感、記憶、注意力集中及心算、語言、視覺空間建構、概念形成，及手部靈巧等功能的評估。本研究主要目的為建立臺灣北部地區健康中老年人的簡短式高級大腦皮質功能檢查量表常模、評估各分測驗之心理計量特性，並探討人口學變項與各分測驗表現的關係。本研究一共收集了臺灣北部地區160名50至89歲、教育程度0年至16年的健康中老年人於簡短式高級大腦皮質功能檢查量表的常模資料，同時也收集MMSE、魏氏智力量表之詞彙、圖形設計、常識、數字符號替代分測驗及工作記憶指數、魏氏記憶量表之邏輯記憶與圖繪記憶分測驗之資料，與臨床病人在本常模量表上的表現，來檢驗本常模量表的效度。其中30位受測者於一個月後進行再測，以考驗本常模量表的再測信度。結果顯示簡短式高級大腦皮質功能檢查量表作為一般認知能力的評估工具，於50歲至89歲的北部地區健康中老年人使用上有良好的心理計量特性，且本研究提供的常模資料具有代表性與適切性。本研究以統計方法排除掉人口學變項對測驗表現的影響，再以校正分數建立百分等級對照表。未來應持續建立簡短式高級大腦皮質功能檢查量表在台灣的完整常模，並可以臨床病人為對象，探討本常模量表在臨床使用上的敏感度與特異性之議題。

The Short-form Higher Cortical Examination is a brief, individually administered neuropsychological test battery measuring orientation, memory, language, attention-concentration, concept formation, visuoconstructional abilities, and manual dexterity. This test battery is intended for use with illiterates or people with low education level. The objectives of this study were to establish the norm of the Short-form Higher Cortical Examination of healthy older adults in North Taiwan, to evaluate its psychometric properties, as well as to examine the relationship between the test performance and demographic variables. The Short-form Higher Cortical Examination was administered to 160 healthy individuals aged 50 to 89 years, with education level varied from 0 to 16 year. The Vocabulary, Block Design, Information, Digit Symbol-Coding subtests, and the Working memory Index of the WAIS-Ⅲ (Chinese Version), the Logical Memory and Visual Reproduction subtests of the WMS-Ⅲ (Chinese Version), and MMSE were also administered , with data collected from clinical groups, to examine the validity of the Short-form Higher Cortical Examination. Thirty of the 160 participants were retested 1 month later to examine the reliability of the Short-form Higher Cortical Examination. The results revealed that the Short-form Higher Cortical Examination showed good test-retest reliability and validity as a neuropsychological test battery measuring general cognitive function, and the local normative data are applicable for the healthy individuals aged from 50 to 89 years. Regression coefficients derived from demographic variables were used to adjust raw scores, and percentile rank norms for these adjusted scores were established. Since the present study only provides normative data for healthy older adults in North Taiwan, further studies on comprehensive collection of norms in other areas of Taiwan are merited. Furthermore, for the effective use of the Short-form Higher Cortical Examination in clinical settings, further studies of specific clinical populations are required.