노인용 언어 학습 검사(Elderly Verbal Learning Test)의 개발 및 표준화 연구 = Development and Standardization of theElderly Verbal Learning Test

다국어 초록 (Multilingual Abstract)

The present study purported to develop a word-list learning test for the elderly Koreans and examine its reliability and validity as a memory assessment tool. The word list of the Elderly Verbal Learning Test (EVLT) consists of nine items from three categories (animal, fruit, household electronics) that are familiar to elderly Koreans. The words were selected based on familiarity, facility of pronunciation, and mental imagery. To examine the validity of the test, EVLT was administerd to 273 normal elderly participants who were over 55 years of age and 25 patients diagnosed with the probable dementia of the Alzheimer's type (DAT). The convergent and discriminant validities were supported by the significant correlation of the EVLT measures with the Memory subtest of the K-DRS and the Story Recall Test, but not with the visuospatial measures, such as the Visuospatial Span and the Construction score of the K-DRS. Factor analysis revealed six factors, which is likely to reflect the memory structure in general population as well as the memory characteristics unique to Korean elders. Discriminant analysis identified significant EVLT measures, which classified 97.3% of the patients with Alzheimer's disease correctly. Interestingly compared with the U.S. adult populations with little educational variance, education proved to be a significant factor in EVLT performance in the elderly Koreans in addition to age and gender. In summary, EVLT appears to be a valid tool for assessing the memory of elderly Koreans, which could assist in effective dementia evaluation.

국문 초록 (Abstract)

본 연구는 국내 노인인구에 적합한 언어학습검사를 개발하고 검사의 신뢰도와 타당도를 검증하여 그 활용 가능성을 확인하고자 하였다. 이를 위해 국내 노인들에게 친숙한 세 의미범주로부터 친숙성, 발음 용이성과 심상형성 용이성을 바탕으로 난이도를 조정한 9개의 단어 자극을 선정하여 노인용 언어학습검사(Elderly Verbal Learning Test; EVLT)를 개발하였다. 검사의 타당도를 검증하기 위해 55세 이상의 정상 장노년 피검자 273명과 알츠하이머성 치매로 진단받은 25명의 환자를 대상으로 검사를 실시하였다. EVLT 측정치들은 K-DRS의 기억 소검사, 이야기 회상 검사 등 기존의 다른 일화적 기억 측정치들과 유의미한 상관을 보였다. 반면, 시공간폭 바로따라하기 검사와는 유의한 상관을 보이지 않아 수렴 및 변별 타당도가 확인되었다. 요인 분석 결과, EVLT는 모두 6개의 구성요인을 가지는 것으로 확인되었는데, 이는 보편적인 성인의 기억 구조와 함께 국내 노인집단 고유의 기억 수행 특징을 반영하는 것으로 보인다. 이에 더하여 EVLT의 임상적 활용 가능성을 알아보고자 알츠하이머성 환자집단과 정상 노인집단 간의 판별분석을 실시한 결과, 도출된 판별함수로 두 집단의 97.3%를 정확하게 분류할 수 있었다. EVLT의 수행에 대한 인구통계학적 변인들의 영향을 살펴보면, 기존 언어학습검사들의 외국 연구에서 확인된 연령과 성별 외에도 교육이 유의미한 영향을 미치는 것으로 나타났다. 이상의 결과들은 EVLT가 국내 노인집단의 언어학습 검사로서 뿐만 아니라 임상장면에서 알츠하이머성 치매를 변별하는 데에도 유용하게 쓰일 수 있음을 시사한다.

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