ABSTRACT

Instruction

In Parkinson’s disease (PD), activities of daily living (ADL) impairments are crucial for diagnosis of dementia (PDD). Performance-based tests are promising tools to discriminate between different levels of cognitive impairment in PD; however, the value of those tests for diagnosis of PDD is only sparsely investigated. Therefore, we evaluated the Erlangen Test of Activities of Daily Living (E-ADL), a time-efficient performance-based ADL test, in PD.

Method

In this cross-sectional study, 40 PD patients with normal cognition (PD-NC), 45 patients with mild cognitive impairment (PD-MCI) and 21 patients with PDD were assessed with a comprehensive ADL and cognitive test battery.

Results

Interrater reliability (r_s =.86) indicated high consistency of the standardized E-ADL scoring system between raters. The E-ADL correlated significantly with other tests of ADL functions (p <.01), highest with an alternative performance-based ADL test (r_s = −.52), and lowest with self-ratings and a physician-rated scale. The E-ADL was also associated with cognitive impairment (p <.01), but also with motor impairment. A binary logistic regression model verified that the E-ADL (p =.04) was an independent predictor of PDD, in addition to motor impairment explaining 53.3% of variance. Receiver operating characteristic curve analysis of the E-ADL revealed an area under the curve of 0.78, a specificity of 77%, and a sensitivity of 67% for diagnosis PDD.

Conclusions

The standardized, easy, and quick to administer E-ADL showed acceptable levels of reliability, and validity in PD and measures cognitive-driven ADL functions. Therefore, it might be a suitable test to support diagnosis of PDD in the clinical daily routine.

中文翻译：

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一种用于帕金森氏病痴呆患者日常生活活动的高效筛查工具

摘要

指令

在帕金森氏病（PD）中，日常生活活动（ADL）障碍对于痴呆症（PDD）的诊断至关重要。基于性能的测试是有前途的工具，可以区分PD中不同程度的认知障碍。但是，这些检查对于诊断PDD的价值只是很少地研究。因此，我们在PD中评估了针对日常活动的Erlangen测验（E-ADL），这是一种基于时间的高效性能ADL测验。

方法

在这项横断面研究中，使用综合的ADL和认知测试电池对40名具有正常认知能力的PD患者（PD-NC），45名轻度认知障碍（PD-MCI）患者和21名PDD患者进行了评估。

结果

评估者之间的信度（r _s  = .86）表明评估者之间标准化E-ADL评分系统具有高度一致性。E-ADL与其他ADL功能测试显着相关（p <.01），与基于性能的替代性ADL测试最高相关（r _s  = -.52），与自评和医师评级量表的相关性最低。E-ADL也与认知障碍有关（p <.01），但也与运动​​障碍有关。二进制logistic回归模型验证了E-ADL（p= .04）是PDD的独立预测因子，另外还有运动障碍，可解释53.3％的方差。E-ADL的接收器工作特征曲线分析显示，曲线下面积为0.78，特异性为77％，诊断PDD的敏感性为67％。

结论

标准化，简单且快速的E-ADL管理在PD中显示出可接受的可靠性和有效性水平，并测量了认知驱动的ADL功能。因此，这可能是支持临床日常诊断PDD的合适测试。