臺灣健康成年人空間知覺功能相關測驗之常模研究

Abstract

背景：視空間知覺（visuospatial perception）是影響我們如何與外在世界互動的基礎認知歷程。路易氏體失智症、帕金森氏症、阿茲海默症等神經退化性疾病，以及腦血管疾病患者、腦傷患者等，皆常見有視空間知覺地受損，而進一步影響其他認知功能。三度空間積木建構測驗以及線條空間判斷測驗在臨床上能提供鑑別診斷、早期偵測、預後與復健等資訊，但台灣尚未有適切的常模資料。目的：本研究主要目的為建立臺灣健康成年人三度空間積木建構測驗及線條空間判斷測驗的常模資料，並探討人口學變項對兩測驗表現的影響，及檢驗測驗的心理計量特性。方法：本研究採分層抽樣，以年齡、性別、教育程度、地理位置等變項分組，收集319位臺灣健康成年人於此兩測驗的常模資料。其中30位參與者於2至4個月後進行再測，以檢驗再測信度。此外，隨機選取30位參與者接受其他神經心理測驗，以檢驗效標關連效度。另外，本研究以回朔方式收集30位阿茲海默型失智症的病人資料，以提供建構效度之檢驗。結果：年齡、教育程度會影響所有的測驗表現，而性別則會影響線條空間判斷測驗的表現。研究結果兩測驗具有適當的再測信度、效標關連效度、與建構效度。結論：兩測驗具有良好的信效度，且常模資料具有良好的代表性、新進性、以及適切性。本研究檢驗人口學變項對測驗表現之影響，並提供校正人口學變項影響後的常模資料，以提供研究者與臨床工作者使用。

Background: Visuospatial perception is a basic cognitive function that influences our interactions with the environment. Impairment of visuospatial perception function is common in patients with dementia with Lewy bodies (DLB), Parkinson’s disease, Alzheimer’s disease, cerebral vascular disease, and traumatic brain injury. These complications might further influence other cognitive functions. In the clinic, the Benton Judgment of Line Orientation (JLO) test and the Benton Three-Dimensional Block Construction (3-DBC) test can provide information for differential diagnosis, early detection, prognosis, and rehabilitation. However, representative normative data for research and clinical practice in Taiwan are lacking. Object: The present study aimed to construct a representative Taiwanese norm for the JLO test and the 3-DBC test. Psychometric properties and influences of demographical variables on the performance of the visuospatial related tests were investigated. Method: We recruited 319 healthy adults stratified by age, educational level, gender, and area of residence. A subgroup of 30 participants was retested at least 2 months later for a test-retest reliability examination. Another subgroup of 30 participants completed other neuropsychological tests for a validity examination. Thirty patients with Alzheimer’s disease were also retrospectively collected for verifying the construct validity. Results: Age and education significantly influenced all performance, and gender affected performance on the JLO test. Our results revealed adequate test-retest reliability, criterion-related validity and construct validity of the JLO test and the 3-DBC test. The normative data showed good representativeness, recency, and relevance. Conclusion: The JLO test and the 3-DBC test have adequate reliability and validity. Our study provides representative and demographic-corrected normative data for research and clinical utility.