語意流暢度測驗在輕度阿茲海默型失智症長者的適用性

研究目的：探討使用不同類別的語意流暢度測驗判別無認知障礙長者以及輕度阿茲海默型失智症患者的適用性。研究方法：以便利取樣招募無認知障礙長者58名與輕度阿茲海默型失智症長者54名，進行七種語意流暢度測驗，分別為：動物類、水果類、蔬菜類、鳥類、交通工具類、五金工具類和樂器類。各別記錄每種測驗類別的正確答題數量做為測驗分數。使用獨立樣本t檢定、皮爾森相關係數分析和多元回歸分析，了解不同測驗時長下，測驗分數與罹病與否、性別、年齡與教育年數之關聯性。使用ROC曲線分析計算不同時長下，每種測驗的最佳切截點、敏感性與特異性。研究結果：罹病與否和所有測驗類別的測驗分數具有顯著關係。性別、年齡與教育年數分別和不同類別的測驗分數具有關聯性，在不同測驗時長下也有所差異。需近一步進行人口學變項的矯正以排除性別、年齡與教育年數對測驗分數的影響。研究討論與結論：在60秒的測驗時長下，可使用具有較高的特異性和敏感性的交通工具類以及性別矯正後的蔬菜類語意流暢度測驗做為施測的選擇。另外在不同的測驗時長下，45秒交通工具類語意流暢度測驗亦有不錯的判別能力；若受試者具有9年以上的教育年數，亦可考慮使用30秒的交通工具類語意流暢度測驗。語意流暢度測驗施測過程方便，但可能因施測者的文化背景和主觀認知影響到計分判斷，因此本研究提供詳細的計分標準以及所有受試者的測驗答案與分類，以維持良好的施測信效度品質。

Purpose: This study aimed to explore the applicability of different semantic fluency tests to discriminate elderly with and without mild dementia of the Alzheimer type (DAT). Method: Convenience sampling method was used in this study, recruiting 58 participants without cognition impairment and 54 participants with mild DAT. All the participants took seven categories of semantic fluency tests: animal, fruit, vegetable, bird, transportation, tool, and musical instrument. The number of correct answers in each test was recorded as the test scores. The independent sample t-test, Pearson correlation coefficient analysis, and multiple regression analysis were used to examine the association between test scores and suffering from DAT or not, gender, age, and years of education under different test durations. ROC curve analysis was used to calculate the optimal cut-off point, sensitivity, and specificity of each test under different durations.Results: There was a significant association between the suffering DAT or not and the test scores of all test categories. Each factor, including gender, age, and years of education, was associated with different categories of test, as well as the various test duration. Adjusted cut-off scores based on demographic variables should be taken to exclude the influence of gender, age, and years of education on test scores.Conclusion and Suggestion: In the 60-second test duration, the transportation and gender-adjusted vegetable semantic fluency test had higher sensitivity and specificity. Under different test durations, the 45-second transportation semantic fluency test also had a good discriminating ability. The 30-second duration transportation semantic fluency test can be applied with people who had more than 9 years of education. This study found that although the semantic fluency test is time-saving, the cultural background and subjective scoring judgment made by the evaluator may affect the test result. Therefore, this study provides detailed conditions for scoring and classified to maintain good reliability and validity.