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Article(id=1322937031353053374, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322936785516503921, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.11.022, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1758124800000, receivedDateStr=2025-09-18, revisedDate=1775923200000, revisedDateStr=2026-04-12, acceptedDate=null, acceptedDateStr=null, onlineDate=1793342367255, onlineDateStr=2026-10-30, pubDate=1781020800000, pubDateStr=2026-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793342367255, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793342367255, creator=13701087609, updateTime=1793342367255, updator=13701087609, issue=Issue{id=1322936785516503921, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='11', pageStart='1809', pageEnd='2000', issueExtLink='null', onlineDate='null', pubDate='1781020800000', pubDateStr='2026-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793342308644, creator='13701087609', updateTime=1793343121351, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940194344796237, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322936785516503921, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940194344796238, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322936785516503921, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1969, endPage=1974, ext={EN=ArticleExt(id=1322937033857052863, articleId=1322937031353053374, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Research progress on assessment tools for subjective memory complaints in the elderly, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This article reviewed the content,characteristics,the advantages and limitations of assessment tools for subjective memory complaints(SMC) in older adults.It aims to provide reference for the development of localized tools and subsequent research,as well as a basis for the scientific assessment of SMC and the construction of effective SMC intervention programs in older adults.

, authors=Menglin LI, Sixue WANG, Yuncui WANG, authorsList=Menglin LI, Sixue WANG, Yuncui WANG, authorCompany=null, correspAuthors=Yuncui WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322937035526385856, articleId=1322937031353053374, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=老年人主观记忆抱怨评估工具的研究进展, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=

对老年人主观记忆抱怨评估工具的内容、特点、优势与局限性进行综述，以期为我国相关工具的开发及后续研究提供参考，为科学评估主观记忆抱怨、构建有效的老年人主观记忆抱怨的干预方案提供依据。

, authors=李梦林, 王思雪, 王云翠*, *, authorsList=李梦林, 王思雪, 王云翠, authorCompany=null, correspAuthors=王云翠, authorNote=

李梦林，硕士研究生在读

, correspAuthorsNote=
王云翠，E-mail：
WANG Yuncui, E-mail:
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李梦林，硕士研究生在读

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pmcid=null, year=2025, volume=81, issue=5, pageStart=2243, pageEnd=2245, url=null, language=null, rfNumber=41, rfOrder=40, authorNames=Mounce G, Greenway K, Brueton V, journalName=Journal of Advanced Nursing, refType=null, unstructuredReference=Mounce G,Greenway K,Brueton V,et al.Approaches to concept clarification:issues for consideration[J].Journal of Advanced Nursing,2025,81(5):2243-2245., articleTitle=Approaches to concept clarification:issues for consideration, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322937036474298561, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322937031353053374, xref=1, ext=[AuthorCompanyExt(id=1322937036788871362, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322937031353053374, companyId=1322937036474298561, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1School of Nursing, Hubei University of Chinese Medicine, Hubei 430065 China), AuthorCompanyExt(id=1322937036864368835, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322937031353053374, companyId=1322937036474298561, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1湖北中医药大学护理学院，湖北 430065)])], figs=[ArticleFig(id=1322937048528728287, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322937031353053374, language=EN, label=Table 1, caption=

Comparison of basic content in evaluation tools

, figureFileSmall=null, figureFileBig=null, tableContent=
评估工具评估方式工具定位主要优势核心局限性信效度
简短问题访谈评估他评/访谈主观感受的定性挖掘灵活深入，适用范围广结果笼统模糊；易受访谈者偏倚未标准化
自制主观记忆视觉评估表自评主观感受的视觉量化直观简便，连续变量过度量化导致内容与原因的“黑箱化”未经大样本验证
SMCQ自评/他评日常与总体记忆功能简短高效，适合社区流行病学初筛工具维度较单一；情绪评估覆盖不足；轻度认知障碍鉴别能力有限信效度良好，跨文化适配
IPQ-M自评/他评个体对记忆问题的疾病感知维度全面；深刻揭示个体对记忆的认知与归因条目繁多，耗时耗力；可行性低信效度良好
MAC-Q自评与年龄相关的记忆表现简短，国际应用广泛缺乏中文版和文化调试；存在干扰因素内部一致性、重测信度高
BECSI自评多维度认知功能工具本土化开发；捕捉早期多维认知变化特异性不足中文版信效度较高
MMQ自评元记忆主观体验工具从元认知深度评估多维度自我意识人群适配性差；评估对象的认知要求过高中英文版信效度均良好
SCD-Q自评/他评病理风险筛查工具基于现代理论框架，认知水平下降的评估维度集中；概念偏差，忽略情绪因素的评估中文版信效度高
M@T他评客观记忆评估记忆程度区分度高；适用于初级保健筛查客观成分偏重；主观感受评估需调查者推断信效度高，鉴别能力强
), ArticleFig(id=1322937048952352992, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322937031353053374, language=CN, label=表1, caption=

评估工具基本内容比较

, figureFileSmall=null, figureFileBig=null, tableContent=
评估工具评估方式工具定位主要优势核心局限性信效度
简短问题访谈评估他评/访谈主观感受的定性挖掘灵活深入，适用范围广结果笼统模糊；易受访谈者偏倚未标准化
自制主观记忆视觉评估表自评主观感受的视觉量化直观简便，连续变量过度量化导致内容与原因的“黑箱化”未经大样本验证
SMCQ自评/他评日常与总体记忆功能简短高效，适合社区流行病学初筛工具维度较单一；情绪评估覆盖不足；轻度认知障碍鉴别能力有限信效度良好，跨文化适配
IPQ-M自评/他评个体对记忆问题的疾病感知维度全面；深刻揭示个体对记忆的认知与归因条目繁多，耗时耗力；可行性低信效度良好
MAC-Q自评与年龄相关的记忆表现简短，国际应用广泛缺乏中文版和文化调试；存在干扰因素内部一致性、重测信度高
BECSI自评多维度认知功能工具本土化开发；捕捉早期多维认知变化特异性不足中文版信效度较高
MMQ自评元记忆主观体验工具从元认知深度评估多维度自我意识人群适配性差；评估对象的认知要求过高中英文版信效度均良好
SCD-Q自评/他评病理风险筛查工具基于现代理论框架，认知水平下降的评估维度集中；概念偏差，忽略情绪因素的评估中文版信效度高
M@T他评客观记忆评估记忆程度区分度高；适用于初级保健筛查客观成分偏重；主观感受评估需调查者推断信效度高，鉴别能力强
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老年人主观记忆抱怨评估工具的研究进展
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李梦林 , 王思雪 , 王云翠 *, *
护理研究 | 科研综述 2026,40(11): 1969-1974
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护理研究 |科研综述 2026 , 40 (11) : 1969 -1974
老年人主观记忆抱怨评估工具的研究进展
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李梦林, 王思雪, 王云翠*, *
作者信息
  • 1湖北中医药大学护理学院，湖北 430065
通讯作者:
王云翠，E-mail：
WANG Yuncui, E-mail:
作者简介:

李梦林，硕士研究生在读

Research progress on assessment tools for subjective memory complaints in the elderly
Menglin LI, Sixue WANG, Yuncui WANG
Affiliations
  • 1School of Nursing, Hubei University of Chinese Medicine, Hubei 430065 China
出版时间: 2026-06-10 doi: 10.12102/j.issn.1009-6493.2026.11.022
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摘要
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对老年人主观记忆抱怨评估工具的内容、特点、优势与局限性进行综述，以期为我国相关工具的开发及后续研究提供参考，为科学评估主观记忆抱怨、构建有效的老年人主观记忆抱怨的干预方案提供依据。

老年人  /  主观记忆抱怨  /  记忆下降  /  评估工具  /  综述

This article reviewed the content,characteristics,the advantages and limitations of assessment tools for subjective memory complaints(SMC) in older adults.It aims to provide reference for the development of localized tools and subsequent research,as well as a basis for the scientific assessment of SMC and the construction of effective SMC intervention programs in older adults.

the elderly  /  subjective memory complaints  /  memory decline  /  assessment tools  /  review
李梦林, 王思雪, 王云翠. 老年人主观记忆抱怨评估工具的研究进展. 护理研究, 2026 , 40 (11) : 1969 -1974 . DOI: 10.12102/j.issn.1009-6493.2026.11.022
Menglin LI, Sixue WANG, Yuncui WANG. Research progress on assessment tools for subjective memory complaints in the elderly[J]. Chinese Nursing Research, 2026 , 40 (11) : 1969 -1974 . DOI: 10.12102/j.issn.1009-6493.2026.11.022
正文
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主观记忆抱怨（subjective memory complaints，SMC）是指个体对自身记忆功能的主观感受下降，同时可能伴随产生认知下降风险、低求助意愿和记忆相关的负面情绪，但客观记忆功能仍处于正常水平，属于老年群体中发生率较高的心理现象[1]。临床上，老年人常同时被报告存在主观记忆下降（subjective cognitive decline，SCD）与焦虑、抱怨等问题[2]，二者并存会提高神经认知障碍的风险。《“健康中国2030”规划纲要》[3]明确提出，“推进老年心理健康与关怀举措，强化老年痴呆症等的有效干预”，其重点关注健全老年人健康服务体系，助力老年人认知障碍类疾病的早期预防与风险管控。主观记忆抱怨的早期筛查及干预有利于早期改善主观记忆抱怨老年人认知功能与调节记忆产生的负面情绪，延缓并阻断疾病的进展。当病情发展成为轻度认知障碍（mild cognitive impairment，MCI）或痴呆时，老年人的自理功能减退[4]，将增加照顾者的压力以及给其家庭带来沉重的负担，同时加剧社会压力。因此，早期评估并干预主观记忆抱怨，一方面，可延缓老年人认知衰退，减轻家庭负担；另一方面，可在一定程度上减少医疗资源消耗，减轻社会层面的经济压力。本研究综述国内外现有主观记忆抱怨评估工具，以期为研究人员合理选择、开发并适配于老年群体的主观记忆抱怨评估工具，制定标准有效的主观记忆抱怨干预方案提供参考。
1　主观记忆抱怨概述
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1.1　概念
主观记忆抱怨最初是于1982年由巴西学者Reisberg等[5]提出，定义为自我报告记忆存在不足但临床测试良好的表现。2014年，Jessen等[6]研究指出，认知测试表现正常的个体若出现主观记忆能力下降，可能是阿尔茨海默病的首发症状。戴中等[7]研究从中医学角度阐述了主观记忆抱怨，认为其缘由是脑力衰弱导致的记忆减退，其将主观记忆抱怨归为“健忘症”，又称“喜忘”“善忘”。2017年，Ellison等[8]研究表明，主观记忆抱怨是指个人主观感受到记忆力的下降而产生抱怨，但不伴有客观的认知功能障碍，成为目前较普遍的含义。2024年，邵凤等[9]研究在此基础上提出记忆、认知、执行功能下降及求助意愿的缺乏、对未知的反应夸大5项概念属性。Yu等[1]也提出了相似的概念属性，并增加了产生记忆相关的负面情绪。需要明确的是，主观记忆抱怨作为一种心理现象可发生于各年龄段。研究表明，年轻人主观记忆抱怨多源于负面情感状态、注意力与执行能力的缺陷、主观幸福感低下以及睡眠不足等非生理性的可逆性因素[10]。相比之下，老年人主观记忆抱怨常与老化性生理衰退、共病影响等不可逆的病理生理过程紧密联系，已被证实是轻度认知障碍与痴呆的重要风险因素。因此，针对老年人主观记忆抱怨的评估与筛查具有更为迫切的临床与研究价值。现阶段主观记忆抱怨的概念属性与评判标准仍未达成共识，导致了主观记忆抱怨的评估工具参差不一。
1.2　研究现状
记忆力下降是老年人衰老认知中的自我刻板化[11]，机体功能和记忆能力会随着人体的衰老而出现进行性衰弱。在多重因素的影响下，老年人易将“正常老化”误判为“痴呆”，进而在一定程度上加剧对主观记忆下降的抱怨[12]，进一步影响老年人心理健康而形成主观记忆抱怨。美国阿尔茨海默病协会（National Institute on Aging-Alzheimer's Association，NIA-AA）已将主观记忆下降纳入正常衰老认知与早期轻度认知障碍的过渡阶段[13]。Mitchell等[14]研究表明，主观记忆抱怨是痴呆的一项独立风险因素，存在主观记忆抱怨的老年人发展成为痴呆的可能性是正常无主观记忆抱怨老年人的2倍，反映出主观记忆抱怨或为痴呆的早期病理变化。患有主观记忆抱怨正常老年人的痴呆患病率也呈现上升趋势[15]。Riedel-Heller等[16]调查显示，有1/3的受访老年人存在主观记忆抱怨。我国老年人主观记忆抱怨的发生率高达76%[17]，主观记忆抱怨与痴呆症的潜在关联已成为神经科学与老年学领域的研究焦点。
2　主观记忆抱怨评估工具
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2.1　简短问题访谈评估
单问题访谈评估工具是通过直接提问的访谈方式，快速筛查可能存在主观记忆抱怨的简便方法。例如，向老年人提问“与1年前相比，您自我感觉记忆力有所下降吗？”若回答“是”则判定可能存在主观记忆抱怨，反之则无[18]。Abdulrab等[19]采用“你记忆力有问题吗”或“你是否感觉记忆力扰乱了你的日常生活”等单问题访谈进行评估筛选。此外，结合分级回答深化访谈，将受访者的记忆力与同龄人或者自身早年时期进行对比，得出记忆等级评分，通过前后两者的评分等级差，判断主观记忆是否呈下降的状态。此方法虽能捕捉到老年记忆的隐性风险[20]，但其结果存在“笼统性”的缺陷，单一的“是”“否”回答无法区分记忆力下降的性质差异，且不同访谈者的提问语气、表达方式以及肢体语言可能会引入主观偏倚，影响筛查结果的准确性。因此，简短问题访谈评估法更适合作为衔接老年人主观记忆体验与量化评估的前置工具。在实际应用中，建议在初步得到肯定回答后，采用统一标准的话术并结合相关量表进行全面评估。既保留其快速筛选的优势，又弥补了多重偏倚造成的结果差异，提升结果的可靠性和解释力。
2.2　主观记忆视觉评估表
戴中等[21]先借助单问题询问访谈开展定性评估，随后运用自制主观记忆视觉评估表对主观记忆抱怨进行定量测评。该评估表设计了一条长100 mm的直线，直线最左端象征记忆力正常，最右端象征记忆力严重下降，访谈者编撰引导语，同时辅以举例说明（例如“最近看到的新闻内容的记忆”），要求被试者依据近1周的自我感知记忆情况在直线上标记。通过测量标记点距直线左端的距离，量化记忆抱怨的程度。视觉评价表降低了老年群体的阅读理解负担，以直观的视觉将内在感受转化为连续变量，适用于表达能力有限，难以直接描述记忆问题的受试人群。然而，该工具未经大样本量测试，缺乏信效度验证；且个体对视觉符号的理解存在差异，仅可作为老年人主观记忆抱怨的辅助性可视化表达，未来应着力弥补其“有量化指标无内容结构”的缺陷，与多维度、标准化评估工具相结合进行综合评估，避免单独作为主观记忆抱怨的评估依据。
2.3　主观记忆抱怨问卷（Subjective Memory Complaints Questionnaire，SMCQ）
该问卷于2009年由韩国学者Youn等[22]编制，包括总体认知（SMCQ-G）和日常记忆（SMCQ-E）2个子量表，共14个条目，回答“是”计1分，“否”计0分，得分越高表明主观记忆抱怨越严重。SMCQ的Cronbach's α系数为0.864、SMCQ-G的Cronbach's α系数为0.694、SMCQ-E的Cronbach's α系数为0.82，是评估老年人主观记忆抱怨可靠、有效的工具。2011年，Can等[23]对SMCQ进行了土耳其本土化改编，土耳其版SMCQ的Cronbach's α系数为0.83，信效度良好。2017年，孟令弟等[24]对SMCQ进行汉化，并对SMCQ-E进行细分，采用3因子结构模型，分为总体记忆、情节记忆和基本记忆3个维度。汉化版SMCQ的Cronbach's α系数为0.872，内部一致性更优，各条目得分与总分间的相关系数及重测信度均高于原版，且具有较高的内容效度。SMCQ作为跨文化适应的评估问卷，具有问题简短、易于施测的特点，能自然捕捉主观记忆感受，适配不同理解与阅读能力的老年人，适用于社区大样本的流行病学的初筛。然而，SMCQ的诊断准确率受到参与人群的影响，特别是针对主动参与调查的人群，他们对认知问题回答更加谨慎而倾向保守回答，导致SMCQ的区分效度不高。另外，该量表的条目围绕记忆的总体和执行状况，忽视了主观记忆抱怨关键的“情绪与情感”维度，其评估更像是一个记忆清单而非一个完整的主观记忆抱怨的心理体验。
2.4　疾病感知问卷-记忆力（the Illness Perception Questionnaire-Memory，IPQ-M）
IPQ-M是于2010年由英国学者Hurt等[25]基于修订版疾病感知问卷修订的，用于评估主观记忆抱怨人群的疾病感知问卷。该问卷共10个维度，在原始问卷IPQ-R[26]记忆部分增加了2个维度，除身份认同维度外，其他均采用Likert 5级评分法（“非常不同意”至“非常同意”），信效度良好。2017年，我国学者唐碧霞[27]对IPQ-M进行文化调试，形成中文版记忆障碍感知问卷。问卷包括症状维度、病情认知和病因3个维度，共86个条目。症状维度采用二级变量计分，回答“是”计1分，“否”计0分；病情认知和病因维度采用Likert 5级评分法（“非常不同意”至“非常同意”），病因维度各条目彼此独立，不累加计分，总量表的Cronbach's α系数为0.873，信效度良好。该问卷条目内容较多，评估耗时长，对老年受访者的注意力和耐心要求较高，不适用于主观记忆抱怨人群快速广泛筛查。IPQ-M更关注个体对记忆问题的心理感受，更适合对已筛查出的主观记忆抱怨人群的感知状况特征进行针对性分析，其结果能反映主观记忆抱怨人群主观认知心理感受特点，预测老年人记忆相关健康行为。实际可以应用于初级保健或二级保健的主观记忆抱怨病人，从而为医疗服务与心理干预的精准匹配提供依据，有利于制定干预措施。
2.5　记忆评估抱怨问卷（Memory Assessment Complaint Questionnaire，MAC-Q）
MAC-Q是由Crook等[28]设计，用以评估与年龄相关记忆下降的简短记忆问卷，共6个条目，前5个条目具体呈现老年人常见的与年龄相关的记忆力衰退的实际表现，采用Likert 5级评分法，“现在好多了”至“现在差多了”分别计1~5分；最后1个条目为整体记忆力下降评估，“现在好多了”至“现在差多了”分别计2~10分，总分越高说明主观记忆抱怨症状越严重，该问卷的Cronbach´s α系数为0.88，信度良好。该问卷利用简洁量化的方式评估老年人的主观记忆困扰。Reid等[29]研究指出，MAC-Q虽具有较好的信度，但其评估结果与情感高度相关，与焦虑和抑郁情绪存在正相关关系。这在一定程度上限制了其作为记忆抱怨筛查工具的效果。目前，MAC-Q尚未检索到中文版，后续研究可保留其简洁的优势，通过增加情绪评估条目或者采用统计控制方法，减轻情感对测量结果的干扰，从而提升其评估的特异性和稳定性。
2.6　简易老年人认知筛查问卷（BECSI）
该问卷的发展历程分为2个阶段，2008年，程灶火等[30]借鉴简易精神状态检查（MMSE）和日常生活活动能力量表（ADL）的范式，编制了老年人认知筛查问卷（BSI-E），其以认知障碍为核心，涵盖日常生活能力等维度。该问卷包括11个维度，共55个条目，各条目采用不同等级计分法，总分182分，得分越低表明受试者脑健康损坏更严重，该问卷的Cronbach´s α系数为0.85，分半信度为0.91，信效度良好。2016年，吴越等[31]在BSI-E的基础上，筛选敏感性高、指向性强的简短条目进行修改和临床试验，最终形成BECSI，该问卷包括记忆功能、时空定向、做事效能和精神症状4个维度，共13个条目，各条目采用Likert 4级评分法，分别计0、1、2、3分，总分39分，得分越高表示受试者认知损害越严重，该问卷的Cronbach´s α系数为0.908，重测信度为0.998，分半信度为0.918，信度与稳定性良好。
BECSI是我国老年认知筛查领域本土化开发的重要实践。但BECSI的部分条目内容涉及客观认知功能测试，这与主观记忆抱怨强调的“主观感受”与“客观表现”分离的概念存在偏差。尽管其包含情绪上的评估，但难以区分其测量的负面情绪是源于客观记忆障碍还是主观感受记忆。该工具目前主要在国内使用，其跨文化适用性仍有待进一步验证。
2.7　多维度记忆问卷（Multifactorial Memory Questionnaire，MMQ）
MMQ是于2002年由Troyer等[32]编制的元记忆自评问卷，包括自我报告记忆的满意度、对日常记忆能力的感知和日常记忆策略及工具的使用3个维度，共57个条目，各条目采用Likert 5级评分法，“非常不同意”至“非常同意”依次计0、1、2、3、4分，得分越高表示受试者对自己的记忆能力越满意、日常记忆能力越强、使用记忆策略更频繁。3个维度的Cronbach´s α系数分别为0.95，0.93，0.83。该问卷已在多个国家翻译应用，已应用于测试不同年龄的人群。2018年，蒋云云等[33]对MMQ进行汉化，调整为记忆能力、内部记忆策略、负性记忆满意度、正性记忆满意度和外部记忆策略5个维度，共51个条目，各维度的Cronbach´s α系数为0.772~0.929，信效度良好。MMQ将主观记忆抱怨引向“元记忆”层面，元记忆是个体对自身记忆的主观意识和思考，主要关注“个体如何审视自己的记忆”而不仅是“你记得怎么样”。中文版MMQ从多维度分析，是深入了解主观记忆抱怨认知机制与影响因素的有力工具。由于其评估的综合性，其条目内容对于老年人而言，可能造成认知负荷、疲劳、敷衍作答等，影响评估的真实性和准确性。
2.8　主观认知下降量表（Subjective Cognitive Decline Questionnaire，SCD-Q）
SCD-Q是于2015年由Gifford等[34]研发，在57个来自评估记忆变化的公开工具的主观记忆下降项目中，采用项目反应理论和计算机化自适应测试模型，筛选出9个适用于主观记忆下降的可靠项目（SCD-Q9），覆盖全局记忆功能、时间比较、日常活动能力等主观记忆感受相关领域特征，为评估主观记忆抱怨提供核心条目支撑。2017年，Hao等[35]以SCD-Q9为工具，对60~80岁常住老年居民分层抽样，探索中文版主观记忆下降主诉筛查量表的研发。2019年，郝立晓等[36]对SCD-Q9进行了汉化，中文版SCD-Q9包含总体记忆功能（4个条目）、日常活动能力（5个条目）2个维度，共9个条目。评分采用混合形式，条目1~条目3、条目6、条目8、条目9采用Likert 2级评分法，回答“否”计0分，“是”计1分，条目4、条目5、条目7采用Likert 3级评分法，“从未”“有时”“经常”分别计0、0.5、1.0分，得分越高表示受试者主观记忆障碍的可能性越大，中文版SCD-Q9的Cronbach´s α系数为0.886，内部一致性良好。该量表在我国文化背景中剖析老年群体主观记忆下降表现特点，适配于我国人群的日常总体记忆认知评估。其有效将主观记忆抱怨的总体记忆功能与痴呆症的病理进程建立联系，提高了评估的临床价值。但该框架忽视了主观记忆抱怨概念中的“与记忆相关的负面情绪”等情绪维度评估，可能会导致其对主观记忆抱怨情绪抱怨方面的评估不足，进而影响对主观记忆抱怨人群的有效筛查。
2.9　记忆改变测试（the Memory Alteration Test，M@T）
M@T是于2007年由Rami等[37]设计的一种筛查测试量表，起初用于区分轻度认知障碍和早期阿尔茨海默病病人。该测试最高分为50分，含40~50道题（题量取决于被试者的自由回忆程度）。内容包括时间定向（5分）、即时记忆（10分）、语义记忆（15分）、自由回忆（10分）和提示回忆（10分）5个维度。M@T的Cronbach´s α系数为0.92，内部可靠性良好。2010年，Rami等[38]采用M@T测试进一步区分主观记忆抱怨、轻度认知障碍和早期阿尔茨海默病病人，结果显示，区分轻度阿尔茨海默病和主观记忆抱怨受试者的敏感性为100%，特异性为86%，判别效度佳。这一鉴别优势同样是评估主观记忆抱怨的核心局限，M@T本质是包含多项客观认知任务的测试，与主观记忆抱怨“客观测试正常”存在潜在的矛盾，M@T评估测评不理想的受试者时，其记忆抱怨可能不再是主观性的，而是客观认知损害产生的负面情绪。因此，M@T并非评估主观记忆抱怨心理现象的首选工具，而是在初步识别出主观记忆抱怨人群后，用于判断其临床风险和进行疾病分期的重要辅助工具。
3　主观记忆抱怨评估工具的比较分析
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为直观对比各工具的核心特征，本研究从评估方式、主要优势与核心局限性等5个维度进行梳理。简短问题访谈、自制主观记忆视觉评估表以及MAC-Q三者均能快速询问获取初步评估结果，虽具备高效筛查的优势，但存在评估结果冗杂、过度量化、易受到研究参与者主观偏倚干扰的局限性。IPQ-M、MMQ采用多维度系统的标准化评估，但其对受试者阅读与反应能力要求较高，实际应用于老年群体的可行性较低。这也反映了社区筛查实践中存在的问题：社区在有限的资源中，如何选择兼具高效性、全面性和准确性的筛查工具。此外，SMCQ、SCD-Q的评估维度滞后于主观记忆抱怨的概念发展，尤其在情感维度的评估存在显著概念缺乏。而BECSI与M@T作为本质上是认知性测试的工具，两者筛查主观记忆抱怨的特异性不足，难以区分客观认知损害导致的情绪与主观性负面情绪。因此，研究者选择与开发评估工具时必须重视工具与概念框架的整合程度。详见表1。
3　当前主观记忆抱怨评估工具存在的问题
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3.1　概念框架模糊，工具开发有限
主观记忆抱怨的概念缺乏统一、标准化的定义，导致现有评估工具在结构维度、内容效度存在显著差异。不少工具仍沿用“记忆衰退”“记忆下降”等传统概念框架。如张静等[39]通过比较不同运动对主观记忆抱怨老年人认知影响时，采用简易精神状态量表（MMSE）及多项客观记忆测试作为主要评估工具。谭丘羽等[40]采用BECSI评估分析主观记忆抱怨在自我老化和痴呆恐惧之间的中介效应。2项研究均单一采取了存在客观的记忆筛查量表，未充分排除客观记忆损害所导致的情绪，与主观记忆抱怨概念的整合性不足，可能会造成测量偏差。
3.2　文化适配性不足，本土化受限
现有主流工具多源于西方文化背景，缺乏针对我国老年群体的文化调试，直接引入可能会造成文化偏差。未来需结合我国人群文化特点与语言习惯进行汉化，以提升本土适用性。
3.3　方法学缺乏标准规范化
部分测量工具（如访谈法、视觉评估等）尚未形成标准化权威性的评估标准，信效度难以保障。未来研究可考虑继续引入国外量表，同时可参考国外评估工具的研发经验。如通过主观记忆抱怨的概念澄清[41]，结合元记忆理论、社会认知理论等分析主观记忆抱怨的心理机制与影响因素，进行清晰的理论界定与维度划分。采用质性研究的非结构化访谈挖掘更多主观记忆抱怨的心理或行为现象，并充分考虑我国老年人人群特点，进行大样本、多中心的调查测试，从而构建更高效、精准、普适的评估工具。
4　小结
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主观记忆抱怨已经作为老年人痴呆症风险的重要信号，主观记忆抱怨的发生率仍处于上升趋势。因此，其评估工具与干预措施的制定已成为目前研究者迫切需要解决的问题。本研究系统梳理了主观记忆抱怨评估工具，指出现有研究常将主观记忆抱怨与认知损害伴发情绪问题相混淆，忽视其“客观认知正常”的核心概念。旨在为后续研究者根据不同的场景需求选择或开发适用性更强的评估工具提供建议与参考。并为构建多维度主观记忆抱怨干预措施，延缓或阻断主观记忆抱怨进展提供理论依据。

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doi: 10.12102/j.issn.1009-6493.2026.11.022
  • 接收时间：2025-09-18
  • 首发时间：2026-10-30
  • 出版时间：2026-06-10
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  • 收稿日期：2025-09-18
  • 修回日期：2026-04-12
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    1湖北中医药大学护理学院，湖北 430065

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