Assessment of cognitive‐driven activity of daily living impairment in non‐demented Parkinson's patients

Becker, Sara; Bäumer, Alena; Maetzler, Walter; Nussbaum, Susanne; Timmers, Maarten; Nueten, Luc Van; Salvadore, Giacomo; D, Zaunbrecher; Röeben, Benjamin; Brockmann, Kathrin; Streffer, Johannes; Berg, Daniela; Liepelt‐Scarfone, Inga

doi:10.1111/jnp.12173

Cited by 21 publications

(41 citation statements)

References 49 publications

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“…This further underlines our findings that the performance in the ETAM is dependent on cognitive functions and its tasks require attention, memory, executive, and visuospatial functions. These results are consistent with other studies (Becker et al, 2018;Bronnick et al, 2006;Cahn et al, 1998;Higginson et al, 2013;Maeshima, Itakura, Nakagawa, Nakai, & Komai, 1997;Pirogovsky, Woods, Filoteo, & Gilbert, 2012). Regarding the individual items, only 'tea making' and 'alarm clock' are not related to cognitive dysfunction, further indicating that these items are not cognitively demanding enough to detect early signs of iADL impairment.…”

Section: Reliability and Item-validity Of The Etamsupporting

confidence: 91%

“…We suggest that mild iADL impairment is closely associated with attention deficits. This finding is supported by other studies linking attentional deficits with iADL (Becker et al, 2018;Bronnick et al, 2006). Other cognitive domains did not differ between the PD-MCI patients with a lowered and those with a high ETAM total score.…”

Section: Etam Sensitivity For Iadl Impairment Associated With Pd-mcisupporting

confidence: 88%

“…While most PD-MCI patients scored on the same level as PD-NC patients and HC, 29.2% scored significantly lower in the ETAM. Other studies showed that about 30% of PD-MCI patients are already impaired in iADL function (Becker et al, 2018;Glonnegger et al, 2016); therefore, the ETAM has a similar detection rate. However, it is an objective iADL test with a standardized scoring system, which can be easily applied in the clinical daily routine.…”

Section: Etam Sensitivity For Iadl Impairment Associated With Pd-mcimentioning

confidence: 79%

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Assessment of Cognitive-Driven Performance-Based Activities of Daily Living Dysfunction in Parkinson’s Disease

Sulzer

Bäumer

Hoang

et al. 2019

J Int Neuropsychol Soc

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Objectives:Parkinson’s disease (PD) patients with mild cognitive impairment (PD-MCI) have an increased risk of developing dementia (PDD). As activities of daily living (ADL) impairment is mandatory for the diagnosis of PDD, assessing early signs of instrumental ADL (iADL) dysfunction, especially in PD-MCI, is essential. In PD, self- and caregiver-reported iADL performance is often confounded by motor dysfunction and mood. Objective and time-efficient performance-based measurements are needed to screen for cognitive-related iADL dysfunction. We evaluated the Erlangen Test of Activities of Daily Living in Mild Dementia and Mild Cognitive Impairment (ETAM) in PD and determined its value for characterizing a subgroup of PD-MCI patients with mild performance-based iADL impairment.Methods:Twenty-one cognitively normal PD patients (PD-NC), 24 PD-MCI patients, and 18 healthy controls (HC) were analyzed. Assessments included the ETAM, a comprehensive neuropsychological test battery, iADL, mood, and motor measurements.Results:PD-MCI patients scored significantly lower on the ETAM total score compared to PD-NC patients (p = .002), whereas HC and PD-NC patients did not statistically differ. No HC scored lower than 27 points (diagnostic cutoff for mild iADL impairment); only PD-MCI patients scored below this cutoff (29.2%) suggesting the ETAM is able to characterize a PD-MCI subgroup with early iADL impairment. PD-MCI patients below the cutoff were more impaired in the attention domain (p = .04).Conclusions:The ETAM is a potentially valuable clinical assessment, able to detect first signs of iADL dysfunction in PD-MCI. Further studies in larger cohorts are needed to evaluate the prognostic ability for predicting PDD.

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Section: Reliability and Item-validity Of The Etamsupporting

confidence: 91%

Section: Etam Sensitivity For Iadl Impairment Associated With Pd-mcisupporting

confidence: 88%

Section: Etam Sensitivity For Iadl Impairment Associated With Pd-mcimentioning

confidence: 79%

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Assessment of Cognitive-Driven Performance-Based Activities of Daily Living Dysfunction in Parkinson’s Disease

Sulzer

Bäumer

Hoang

et al. 2019

J Int Neuropsychol Soc

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“…Among the participants with AD, MCI, and healthy older adults, reduced executive performance has been particularly associated with poorer IADLs, 35,36 and interventions to improve executive functions have been suggested as a means to increase independence. 37 In PD, memory, executive function, processing speed, language, and visuospatial skills have been variably associated with complex IADLs, 10,11,38 although other studies that evaluate performance-based methods of IADL assessment have found no relationship between cognition and functional performance in participants with PD. 3,39 Here, we provide support for associations with both cognitive diagnosis and individual cognitive tests, particularly processing speed and working memory.…”

Section: Discussionmentioning

confidence: 99%

Participant and Study Partner Reported Impact of Cognition on Functional Activities in Parkinson's Disease

Cholerton

Poston

Tian

et al. 2019

Movement Disord Clin Pract

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Introduction Introduction: Cognitive dysfunction is common in Parkinson's disease (PD) and associated with reduced functional abilities and increased dependence. To date, however, little is known about the relationship between performance of instrumental activities of daily living (IADLs) and cognitive stages in PD, and there are conflicting reports as to whether declines in specific cognitive domains predict IADL impairment. Methods Methods: Participants with PD were drawn from the Pacific Udall Center and included in the study if both participant and study partner IADL ratings and cognitive tests were completed (n = 192). Logistic regression analyses were performed to determine whether participant and/or study partner rating predicted mild cognitive impairment or dementia. Correlations are reported for the relationship between participant/study partner IADL reports as well as for specific cognitive tests. ResultsResults: Although both participant and study partner ratings of IADL performance were associated with a diagnosis of PD with dementia, only participant self-rating of functional ability was significantly associated with a diagnosis of PD with mild cognitive impairment. Functional ability correlated most strongly with measures of processing speed, auditory working memory, and immediate verbal recall for both the participant and study partner ratings. Conclusion Conclusion: For participants with PD in the early stages of cognitive decline, self-rating may be more sensitive to the impact of cognitive changes on IADL function than ratings made by a knowledgeable study partner. Changes in executive function, processing speed, and learning may indicate a higher likelihood of IADL impairment. Careful assessment of cognition and IADL performance is recommended to permit individualized interventions prior to significant disability.Cognitive impairment is pervasive in Parkinson's disease (PD), often resulting in devastating impacts on quality of life, functional performance, and independence. 1 A decline in the ability to perform instrumental activities of daily living (IADL) related to cognitive impairment, although often initially subtle, can negatively impact disease outcome if not identified and adequately compensated. 2 Although significant functional impairment may be more apparent in PD-related dementia (PDD), subtle deficits in complex IADLs occur frequently among those with PDrelated mild cognitive impairment (PD-MCI), and the presence of such deficits may help to reveal the presence of early cognitive decline. 3 The assessment of functional change in PD presents challenges, however. Performance-based measures are not often

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“…The aim of the ongoing, longitudinal ABC-PD study [12] is to assess disease progression of PD patients with and without (probable) amyloid beta pathology. One hundred PD patients selected according to their CSF Aß42 profile were recruited from the outpatient clinic of the department of Neurodegeneration at the University of Tübingen.…”

Section: Cohort Bmentioning

confidence: 99%

Effects of Levodopa on quality of sleep and nocturnal movements in Parkinson’s Disease

et al. 2021

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Background Sleep disturbances are common in Parkinson’s Disease (PD), with nocturnal akinesia being one of the most burdensome. Levodopa is frequently used in clinical routine to improve nocturnal akinesia, although evidence is not well proven. Methods We assessed associations of Levodopa intake with quality of sleep and perception of nocturnal akinesia in three PD cohorts, using the Parkinson’s Disease Sleep Scale (PDSS-2) in two cohorts and a question on nocturnal immobility in one cohort. In one cohort also objective assessment of mobility during sleep was performed, using mobile health technology. Results In an independent analysis of all three cohorts (in total n = 1124 PD patients), patients taking Levodopa CR reported a significantly higher burden by nocturnal akinesia than patients without Levodopa. Higher Levodopa intake and MDS-UPDRS part IV scores (indicating motor fluctuations) predicted worse PDSS-2 and higher subjective nocturnal immobility scores, while disease duration and severity were not predictive. Levodopa intake was not associated with objectively changed mobility during sleep. Conclusion Our results showed an association of higher Levodopa intake with perception of worse quality of sleep and nocturnal immobility in PD, indicating that Levodopa alone might not be suitable to improve subjective feeling of nocturnal akinesia in PD. In contrast, Levodopa intake was not relevantly associated with objectively measured mobility during sleep. PD patients with motor fluctuations may be particularly affected by subjective perception of nocturnal mobility. This study should motivate further pathophysiological and clinical investigations on the cause of perception of immobility during sleep in PD.

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Assessment of cognitive‐driven activity of daily living impairment in non‐demented Parkinson's patients

Cited by 21 publications

References 49 publications

Assessment of Cognitive-Driven Performance-Based Activities of Daily Living Dysfunction in Parkinson’s Disease

Assessment of Cognitive-Driven Performance-Based Activities of Daily Living Dysfunction in Parkinson’s Disease

Participant and Study Partner Reported Impact of Cognition on Functional Activities in Parkinson's Disease

Effects of Levodopa on quality of sleep and nocturnal movements in Parkinson’s Disease

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