Predictors of performance-based measures of instrumental activities of daily living in nondemented patients with Parkinson’s disease

Pirogovsky, Eva; Martinez-Hannon, Mercedes; Schiehser, Dawn M.; Lessig, Stephanie; Song, David; Litvan, Irene; Filoteo, J. Vincent

doi:10.1080/13803395.2013.838940

Cited by 32 publications

(43 citation statements)

References 26 publications

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“…Our results indicate that the KI PDAQ was more strongly associated with the gold-standard performance-based measures of cognitive functioning than was the PT PDAQ, which is consistent with previous studies, [8][9][10][11] showing that as PD patients decline cognitively from NC to MCI to PDD, they become less accurate in assessing their functional abilities.…”

Section: Discussionsupporting

confidence: 91%

“…PT with and without PD may be unable to give valid self‐assessments of their cognitive deficits, tending to rate their disability as less severe than knowledgeable informants (KI) . It has been shown that even mildly cognitively impaired PD PT can misrepresent performance on IADLs, leading to disagreement with KI . Similarly, PT and KI discrepancy has been found to increase as PT depression worsens, leading PD PT to underestimate their cognitive limitations .…”

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confidence: 99%

“…[5][6][7] It has been shown that even mildly cognitively impaired PD PT can misrepresent performance on IADLs, leading to disagreement with KI. [8][9][10] Similarly, PT and KI discrepancy has been found to increase as PT depression worsens, leading PD PT to underestimate their cognitive limitations. [11][12][13][14][15] KI depression, burden, and stress can also lead to an underestimation of PT's functional status and an overestimation of their disabilities.…”

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confidence: 99%

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Cognitive Functional Abilities in Parkinson's Disease: Agreement Between Patients and Informants

Deck

Xie

Choi

et al. 2019

Movement Disord Clin Pract

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Background The Penn Parkinson's Daily Activities Questionnaire‐15 (PDAQ‐15) assesses cognition‐related instrumental activities of daily living (IADL) in Parkinson's disease (PD). Objectives To assess the degree and predictors of disagreement between patients (PT) and knowledgeable informants (KI) on the PDAQ‐15. Methods We recruited 254 PT and KI pairs (PT‐KI), determined predictors of agreement, and compared scores to a performance‐based functional measure (Direct Assessment of Functional Status [DAFS]; N = 61). Results PT and KI total score (intraclass correlation = 0.57) and individual item (Cohen's kappa = 0.46–0.62) agreement were moderate. Patient depression, global cognition, and caregiver burden (all P < 0.05), predicted PT‐KI discrepancy. PT‐KI discrepancy was highest in patients with a dementia diagnosis, followed by mild cognitive impairment and then normal cognition (all P < 0.01), with PT rating themselves relatively more functionally intact as cognition worsened. DAFS performance was more highly correlated with KI (r = 0.82; P < 0.001) than PT (r = 0.62; P < 0.001) PDAQ‐15 score. Conclusions Our results support using KI as proxies when assessing cognitive IADLs in PD PTs, particularly in cases of more advanced cognitive decline.

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Section: Discussionsupporting

confidence: 91%

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confidence: 99%

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confidence: 99%

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Cognitive Functional Abilities in Parkinson's Disease: Agreement Between Patients and Informants

Deck

Xie

Choi

et al. 2019

Movement Disord Clin Pract

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“…Además. debemos tener en cuenta que las actividades entre hombres y mujeres suelen diferir en todas las etapas de la vida (2,9,10,(38)(39)(40)(41) . Sin embargo, resulta útil el empleo del índice de Lawton, ya que según algunos autores, puede detectar de manera precoz una dependencia funcional (42,43) .…”

Section: Discussionunclassified

Asociación entre depresión y dependencia funcional en pacientes adultos mayores

et al. 2017

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RESUMENObjetivo: Determinar la asociación entre depresión y dependencia funcional en pacientes adultos mayores del Centro Geriátrico Naval. Materiales y métodos: Estudio retrospectivo, transversal y analítico de un análisis secundario de base de datos, con un tamaño muestral por conveniencia de 625 adultos mayores. Resultados: En el análisis de regresión lineal de predicción de dependencia funcional según índice de Barthel, se encontró que, por cada punto obtenido en el cuestionario de Yesavage, disminuye en 4,8±1.82 puntos el índice de Barthel y, por 5 puntos, disminuye 29.99±3.62 puntos. En relación con el Índice de Lawton, se encontraron resultados significativos respecto a la edad, sexo, grado militar, rendimiento físico, fuerza de prensión y depresión. Conclusiones: Se evidenció asociación entre depresión y dependencia funcional para actividades básicas e instrumentales de la vida diaria. Asimismo, que a mayor riesgo de depresión, mayor probabilidad de presentar dependencia funcional según el índice de Barthel, independientemente de otras variables.Palabras Claves: Adulto mayor; depresión; discapacidad (Fuente: DeSC BIREME). Association between depression and functional dependence in elderly patientsABSTRACT Objective: To determine the association between depression and functional dependence in elderly patients of the Centro Geriátrico Naval (Peruvian naval medical center for elderly people). Materials and methods: A retrospective, cross-sectional, analytic study conducted from a secondary data analysis, with a convenience sample size of 625 elderly people. Results: In the linear regression analysis which predicts functional dependence according to the Barthel Index, it was found that, for each point in the Yesavage questionnaire, the Barthel Index score decreases 4.8±1.82 points and, for every 5 points, it decreases 29.99±3.62 points. In relation to the Lawton Index, significant outcomes were found regarding age, gender, military rank, physical performance, grip strength and depression. Conclusions:The results show an association between depression and functional dependence in performing basic and instrumental activities of daily life. Moreover, the higher the risk of depression, the higher the chance of developing functional dependence according to the Barthel Index, regardless of other variables.

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“…Loss of instrumental ADL functions in some patients precedes cognitive decline and PDD (Reginold et al, 2012), yet cognition and ADL function might worsen in parallel (Rosenthal et al, 2010). Little is known about the nature of ADL performance in PD-MCI, although in some patients with PD-MCI, the first signs of ADL disabilities have been reported (Glonnegger et al, 2016;Martin et al, 2013;Pirogovsky et al, 2013). Therefore, mild ADL impairment in PD-MCI may characterize those patients at high risk for PDD.…”

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confidence: 99%

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

Becker

Bäumer

Maetzler

et al. 2018

Journal of Neuropsychology

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The core criterion for Parkinson's disease dementia (PDD) is the impairment in activities of daily living (ADL) function primarily caused by cognitive, not motor symptoms. There is evidence to assume that mild ADL impairments in mild cognitive impairment (PD‐MCI) characterize those patients at high risk for dementia. Data of 216 Parkinson's disease (PD) patients assessed with comprehensive motor and neuropsychological assessments were analysed. Based on linear regression models, subscores of the Functional Activities Questionnaire (FAQ) primarily reflecting patients’ global cognitive status (FAQC) or PD‐related motor severity (FAQM) were developed. A quotient (FAQQ) of both scores was calculated, with values >1 indicating more cognitive‐ compared to motor‐driven ADL impairment. Both FAQC and FAQM scores were higher in PD‐MCI than cognitively normal (PD‐CN) patients, indicating more severe cognitive‐ and motor‐driven ADL impairments in this group. One third (31.6%) of the PD‐MCI group had a FAQQ score >1, which was significantly different from patients with PD‐CN (p = .02). PD‐MCI patients with an FAQQ score >1 were more impaired on tests assessing attention (p = .019) and language (p = .033) compared to PD‐MCI patients with lower FAQQ values. The differentiation between cognitive‐ and motor‐driven ADL is important, as the loss of functional capacity is the defining factor for a diagnosis of PDD. We were able to differentiate the cognitive‐driven from the motor‐driven ADL impairments for the FAQ. PD‐MCI patients with more cognitive‐ compared to motor‐driven ADL impairments may pose a risk group for conversion to PDD and can be targeted for early treatments.

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Predictors of performance-based measures of instrumental activities of daily living in nondemented patients with Parkinson’s disease

Cited by 32 publications

References 26 publications

Cognitive Functional Abilities in Parkinson's Disease: Agreement Between Patients and Informants

Cognitive Functional Abilities in Parkinson's Disease: Agreement Between Patients and Informants

Asociación entre depresión y dependencia funcional en pacientes adultos mayores

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

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