The Multiple Object Test as a Performance Based Tool to Assess Cognitive Driven Activity of Daily Living Function in Parkinson’s Disease

Glonnegger, Hannah; Beyle, Aline; Cerff, Bernhard; Gräber, Susanne; Csóti, Ilona; Berg, Daniela; Liepelt‐Scarfone, Inga

doi:10.3233/jad-160173

Cited by 14 publications

(23 citation statements)

References 29 publications

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“…So far, only a few studies have focused on the evaluation of performance-based ADL tests for the early and valid diagnosis of PDD [ 7 , 12 ]. Recently, we confirmed good diagnostic accuracy of the Multiple Object Test (MOT), a quick and easy to apply performance-based ADL test for PDD [ 13 ]. Besides quantitative aspects, the MOT offers the possibility to evaluate qualitative characteristics of ADL dysfunction, e.g.…”

Section: Introductionmentioning

confidence: 79%

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The Multiple Object Test as a performance-based tool to assess the decline of ADL function in Parkinson’s disease

et al. 2018

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IntroductionAs cognitive-driven worsening of activities of the daily living (ADL) in Parkinson’s disease (PD) is the core feature of PD dementia (PDD), there is great need for sensitive quantitative assessment. Aim of our study was the evaluation of cognitive-driven worsening of ADL by the performance-based Multiple Object Test (MOT), offering an essential clinical advantage as it is quick and easy to apply in a clinical context even on severely impaired patients.Methods73 PD patients were assessed longitudinally over a period of 37 (6–49) months. According to their neuropsychological profile the sample was divided into two groups: PD patients with (n = 34, PD-CI) and without cognitive impairment (n = 39, PD-noCI). The MOT comprises five routine tasks (e.g. to make coffee) quick and easy to apply. Quantitative (total error number, processing time) and qualitative parameters (error type) were analyzed using non-parametric test statistic (e.g.Wilcoxon signed-rank test, binary logistic regression).ResultsMedian number of total errors (p = 0.001), processing time (p<0.001), perplexity (p = 0.035), and omission errors (p<0.001) increased significantly from baseline to follow-up in the total sample. Worsening of MOT performance was correlated to cognitive decline in the attention/ executive function and visuo-constructive domain. PD-CI showed an increase in omission errors (p = 0.027) compared to PD-noCI over time. This increase in omission errors between visits was further identified as a risk marker for PDD conversion.ConclusionThe MOT, especially frequency of omission errors, is a promising tool to rate PD patients objectively and might help to identify patients with a high risk for having mild cognitive impairment or dementia.

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Section: Introductionmentioning

confidence: 79%

“…It has been speculated that the MOT has the potential to predict progressive cognitive decline [ 13 ]. Thus, aim of the study was to evaluate changes in the MOT over 3 years in a group of PD patients with and without cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

The Multiple Object Test as a performance-based tool to assess the decline of ADL function in Parkinson’s disease

et al. 2018

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“…Previous studies have investigated alternative performance‐based functional measures in PD, including the Medication Management Ability Assessment (MMAA), the Performance Assessment of Self‐Care Skills (PASS), and the Multiple Object Test (MOT) . However, most of these studies focused on nondemented PD populations.…”

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confidence: 99%

Validation of a performance‐based assessment of cognitive functional ability in Parkinson's disease

et al. 2018

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Background: Outcome measures that capture functional abilities related to cognition offer the potential to demonstrate real-world effectiveness of cognitive-enhancing treatments. However, distinguishing functional disability related to cognition from that attributed to motor symptoms can be difficult in PD. A performance-based functional assessment allows for direct observation of activity of daily living skills and separation of cognitive from motoric disabilities. Objectives: Validate the University of California San Diego Performance-Based Skills Assessment in PD. Methods: One hundred PD participants, ranging from normal cognition to dementia, completed the University of California San Diego Performance-Based Skills Assessment, a performance-based measure of cognitively demanding activities of daily living, as well as a neuropsychological battery and motor examination. Cognitive classification was determined by consensus conference, blinded to University of California San Diego Performance-Based Skills Assessment scores. Psychometric properties of the University of California San Diego Performance-Based Skills Assessment, including internal consistency, test-retest and inter-rater reliability, and discriminant validity for dementia, were examined. Results: The University of California San Diego Performance-Based Skills Assessment demonstrated strong internal consistency (Cronbach’s α = 0.82) and test-retest reliability (r = 0.89) and correlated strongly with global cognition (Mattis Dementia Rating Scale: r = 0.80; P < 0.001). University of California San Diego Performance-Based Skills Assessment regression models indicated greater contribution from cognitive explanatory variables (marginal partial: R2 = 0.33) than motor variables (marginal partial: R2 = 0.05), controlling for age, education, disease duration, and l-dopa equivalent dose. Additionally, the University of California San Diego Performance-Based Skills Assessment exhibited strong discriminant validity for dementia (area under the curve = 0.91). Conclusions: The University of California San Diego Performance-Based Skills Assessment is a valid measure of functional abilities related to cognition rather than motor symptoms in PD. Furthermore, it reliably distinguishes demented from nondemented participants. The University of California San Diego Performance-Based Skills Assessment may be considered as an outcome measure that combines cognitive and functional abilities in treatment trials for cognitive impairment in PD.

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

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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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The Multiple Object Test as a Performance Based Tool to Assess Cognitive Driven Activity of Daily Living Function in Parkinson’s Disease

Abstract: Performance based testing is promising to identify quantitative and qualitative ADL aspects differentiating between different cognitive groups which might be helpful for an early detection of PDD.

Cited by 14 publications

References 29 publications

The Multiple Object Test as a performance-based tool to assess the decline of ADL function in Parkinson’s disease

The Multiple Object Test as a performance-based tool to assess the decline of ADL function in Parkinson’s disease

Validation of a performance‐based assessment of cognitive functional ability in Parkinson's disease

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

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