臺灣博碩士論文加值系統

本研究將魏氏記憶力量表中文版中三項語文記憶分測驗︰邏輯記憶、字詞配對、與字詞學習等分測驗，以及其他國內常用之認知功能測驗應用於國內阿茲海默型失智症病患，並以正常對照組、極輕度失智症組做比較，希望找出最有預測力的測驗，以利國內臨床工作及相關學術研究。共有84名受試者參與研究，經診斷為阿茲海默型失智症的輕度失智症組有20人，極輕度失智症組有34人，正常對照組有30人。結果顯示各組在三項魏氏記憶力量表語文記憶分測驗上各有差異，其中邏輯記憶分測驗應用於早期偵測，區辨正常對照組與極輕度失智症組有較好的效果，若要應用於區辨是否有失智症，則以邏輯記憶分測驗加上字詞配對分測驗所組成之聽覺延宕記憶指標較有效。其他認知功能方面則顯示區辨正常對照組與極輕度失智症組上，語意流暢測驗是較有效的，應用於區辨是否有失智症上，則要再加上抽象推理與空間建構的測驗，顯示失智症初期，語言及執行功能相關的障礙是最為常見的。研究結果可提供國內學術研究與臨床工作者，應用魏氏記憶力量表以及其他認知功能測驗於失智症評估之參考，並建議國內相關研究可注意之現象。

The present study compared the performance of 20 patients (CDR=1) of Alzheimer’s Disease (AD) with 34 very mild dementia participants (CDR=0.5) and 30 normal control participants (CDR=0) on three verbal memory subtests in the Chinese Version of the Wechsler Memory Scale-III, including Logical Memory, Verbal Paired Associates, and Word List Learning. The researcher also used other cognitive tests that were commonly used in Taiwan in order to find out which non-memory tests have the most discriminative power for the diagnosis of dementia. Results revealed that in memory tests, the Auditory Delayed Index of the Weschler Memory Scale, which was calculated by the results of Logical Memory II and Verbal Paired Associates II, was the most predictive variable in differentiation between AD patients and normal participants. For early detection of dementia, Logical Memory subtest was found to be the best predictor for very mild dementia. In other cognitive functions, tests related to language and executive function had the most predictive value in differentiation between AD patient and normal control, such as Category Fluency, Proverbs, and Three-Dimensional Block Construction. The results of the present study provided clinical evidence for the application of the Weschler Memory Scale-III (Chinese Version) and recommendations for further study in Taiwan were also suggested.

目錄
中文摘要 I
英文摘要 II
誌謝 III
表目錄 VII
圖目錄 VIII

第一章 緒論 1
第一節 阿茲海默型失智症 2
壹、DSM-IV的診斷準則 3
貳、NINCDS-ADRDA的診斷準則 5
參、兩種診斷準則之比較 8
第二節 阿茲海默型失智症之盛行率 9
第三節 阿茲海默型失智症的病程發展及主要認知障礙之相關研究 10
壹、病程發展 10
貳、主要認知症狀與相關研究 11
第四節 魏氏記憶力量表 (The Wechsler Memory Scale, WMS) 20
壹、字詞類記憶力測驗 21
貳、三項聽覺記憶指標 24
第五節 研究目的與假設 25
第二章 方法 28
第一節 受試者 28
第二節 研究工具 31
第三節 步驟 36
第三章 結果 37
第一節 受試者在魏氏記憶力量表語文記憶分測驗上之表現 37
第二節 受試者在其他認知功能測驗上之表現 42
第三節 區辨分析 46
壹、魏氏記憶力量表語文記憶分測驗 46
貳、其他認知功能 47
第四章 討論 53
第一節 魏氏記憶力量表語文記憶分測驗 53
第二節 其他認知功能 55
第三節 研究貢獻、限制、與未來研究方向 57
參考文獻 60














表目錄
表1. 各組受試者之人口學變項及臨床資料 30
表2-1 年齡與魏氏記憶力量表語文記憶分測驗之相關 38
表2-2. 邏輯記憶分測驗變異數分析之結果 38
表2-3. 字詞配對分測驗變異數分析之結果 39
表2-4. 聽覺記憶指標變異數分析之結果 40
表2-5. 字詞學習分測驗變異數分析之結果 40
表3-1. 年齡與其他認知功能測驗之相關 42
表3-2. 定向感變異數分析之結果 (以年齡作為共變項) 43
表3-3. 學習與記憶功能變異數分析之結果 (以年齡作為共變項) 44
表3-4. 語言功能變異數分析之結果 (以年齡作為共變項) 45
表3-5. 視空間建構、算數、以及抽象推理功能變異數分析之結果 (以年齡作為共變項) 45
表4-1. 區辨分析 – 魏氏記憶力量表 語文記憶分測驗 47
表4-2. 區辨分析 簡式高級大腦皮質功能檢查量表 (A組與B組) 49
表4-3. 定向感與記憶力各測驗與區辨函數之相關 (A組與B組) 49
表4-4. 其他認知功能各測驗與區辨函數之相關 (A組與B組) 49
表4-5. 區辨分析 簡氏高級大腦皮質功能檢查量表 (A組與C組) 51
表4-6. 定向感與記憶力各測驗與區辨函數之相關 (A組與C組) 51
表4-7. 其他認知功能各測驗與區辨函數之相關 (A組與C組) 52

圖目錄
圖1. 字詞學習分測驗立即回憶部分 (WLL-I) 量表分數與得分人數 41
圖2 字詞學習分測驗延宕回憶部分 (WLL-II) 量表分數與得分人數 41
圖3. 各分測驗之平均量表分數 54

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