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

Published online by Cambridge University Press:  11 December 2019

Patricia Sulzer Open the ORCID record for Patricia Sulzer [Opens in a new window] ,
Alena Bäumer ,
Huong Giang Hoang ,
Sara Becker ,
Hannah Dorothea Lönneker ,
Elmar Graessel  and
Inga Liepelt-Scarfone
Patricia Sulzer
Affiliation:
Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076 Tübingen, Germany
Alena Bäumer
Affiliation:
Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076 Tübingen, Germany
Huong Giang Hoang
Affiliation:
Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076 Tübingen, Germany
Sara Becker
Affiliation:
Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076 Tübingen, Germany
Hannah Dorothea Lönneker
Affiliation:
Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076 Tübingen, Germany
Elmar Graessel
Affiliation:
Department for Psychiatry and Psychotherapy, Center for Health Services Research in Medicine, University Clinic Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
Inga Liepelt-Scarfone*
Affiliation:
Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Otfried-Müller-Straße 27, 72076 Tübingen, Germany German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076 Tübingen, Germany
*
*Correspondence and reprint requests to: PD Dr. Inga Liepelt-Scarfone, Hoppe-Seyler-Str. 3, D-72076 Tübingen, Germany. Phone: +4970712980424; Fax: +497071294490. E-mail: inga.liepelt@uni-tuebingen.de.
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Abstract

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.

Keywords

Cognitive dysfunctionNeuropsychologyAttentionCognitionDisease progressionNeuropsychological tests
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 26 , Issue 4 , April 2020 , pp. 430 - 440
Copyright
Copyright © INS. Published by Cambridge University Press, 2019

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