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메타분석을 통한 주·객관적 인지-언어 평가 간 상관성 연구 : 정상 노년층, MCI, 치매 환자를 중심으로

Meta-Analysis of Correlation Between Subjective and Objective Cognitive-Linguistic Tests : Focused on Normal Aging, MCI, and Dementia

  • 이미숙 (공주대학교 특수교육대학원 언어재활 전공)
  • Lee, Mi-Sook (Graduate School of Special Education(Speech Rehabilitation), Kongju National University)
  • 투고 : 2015.10.08
  • 심사 : 2015.11.06
  • 발행 : 2015.11.30

초록

인지-언어 능력에 대한 노인들의 주관적 호소는 경도인지장애나 치매로의 진전을 예측하는 중요 요인이다. 그러나, 인지-언어 능력의 주 객관적 평가 간 상관성은 연구마다 상이하다. 특히, 양자 간 상관성을 체계적으로 살펴본 국내 연구는 매우 드물다. 본 연구에서는 2000년 이후 게재된 국내외 문헌 중 총 26개 논문을 대상으로 메타분석을 실시함으로써 정상 노년층, MCI, 치매 집단의 자기 보고형 및 정보제공자 보고형 평가와 객관적 평가 간 상관성을 알아보고자 하였다. 질적 분석 결과, 분석에 포함된 연구 대상자의 수는 26~657명이었다. 주관적 평가의 유형은 자기 보고형 75.4%, 정보제공자 보고형 24.6%였으며, 객관적 평가의 하위 영역은 기억력, 전반적 인지능력, 언어능력 등의 순으로 많았다. 메타분석 결과, 자기 보고형 평가와 객관적 평가 간 상관성은 치매 집단이 가장 높았고, 정보제공자 보고형은 세 집단 모두에서 효과적이었다. 객관적 평가의 하위 영역별로는, 정상 노년층에서 자기 보고형과 추론력, 정보제공자 보고형과 기억력 및 언어능력 간에 상관성이 높았다. MCI에서는 자기 보고형과 언어능력 등, 정보제공자 보고형과 전반적 인지능력 등의 영역 간에 높은 상관성이 있었고, 치매 집단에서는 두 유형 모두 기억력, 언어능력, 전반적 인지능력을 잘 반영하였다. 본 연구는 세 집단의 인지-언어 능력에 대한 두 유형의 주관적 평가와 객관적 평가 간 상관성을 체계적으로 분석함으로써 증거 기반적 자료를 제공할 수 있다.

Subjective cognitive-linguistic complaints in older adults contribute to the diagnostic and prognostic investigation of MCI or dementia. However, the utility of subjective test for predicting cognitive-linguistic decline is controversial. Few domestic studies have included the correlation between subjective and objective tests systematically. The current study analyzed 26 studies published since 2000, and the effect sizes of their correlation coefficients between two tests were computed. The results of qualitative analysis indicated that the number of subjects ranged from 26 to 657. Subjective tests included the self-report 75.4% and the informant-report 24.6%. In objective tests, memory comprised the largest proportion, followed by global cognition, and language, etc. As a result of meta-analysis, self-report test had the predictive value for dementia, and informant-report test contributed to discriminate among 3 groups. In the elderly group, self-report test was correlated with reasoning, and informant-report test with memory and language. In MCIs, self-report test predicted several abilities including language, and informant-report test signaled the future decline of domains like global cognition. Two types of subjective tests in dementia also represented memory, language, and global cognition accurately. This study provides evidence-based information to support relationships between subjective and objective tests for cognitive-linguistic ability in 3 groups.

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