| Summary: | 碩士 === 高雄醫學大學 === 職能治療學研究所 === 102 === “Vascular Cognitive Impairment” (VCI) has become an umbrella term for the cognitive disorder due to cerebrovascular disease for early detection of vascular dementia .” Instrumental Activity of Daily Living (IADL) ability of VCI patients is affect by their cognitive impairment, which is decline continuously and gradually. IADL deterioration should be similar to cognitive decline, but most research cannot present the change objectively.
The present research investigated the IADL ability of 49 healthy elders and 97 cerebrovascular disease patients with a performance-based measurement-- Taiwan Performance- based IADL (TPIADL), and assessed their cognitive ability and actual activity of daily living performance with cognitive tests and questionnaires. The convergent and criteria validity of the TPIADL for VCI patients were examined.
The performance on TPIADL tests differed among groups, worsening with increased cognitive impairment level. High correlation was shown between TPIADL, Mini- Mental State Examination (r=-0.806, p=0.000) and cognitive domain of IADL scale (r=-0.756, p=0.000). The area under the relative operating characteristic curve was 0.847 ~0.888 (95% CI=0.755~ 0.965, p=0.000) to differentiate dementia and others. The optimal cut-off point for the TPIADL was 6/7, which gave a sensitivity of 0.733 and a specificity of 0.731~0.845.
TPIADL presented to detect the change of IADL ability of VCI patients. TPIADL has strong correlation with Mini- Mental State Examination and cognitive domain of IADL scale, which means good validity of TPIADL. The optimal cut-off point for the TPIADL was 6/7 to differentiate vascular dementia and others, which assert the values of using TPIADL as the diagnosis assistance.
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