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Assessment of cognitive-driven activity of daily living impairment in non-demented Parkinson's patients.
Journal of Neuropsychology ( IF 2.0 ) Pub Date : 2018-10-15 , DOI: 10.1111/jnp.12173
Sara Becker 1, 2 , Alena Bäumer 1, 2 , Walter Maetzler 1, 3 , Susanne Nussbaum 1, 2 , Maarten Timmers 4, 5 , Luc Van Nueten 4 , Giacomo Salvadore 6 , Detlev Zaunbrecher 7 , Benjamin Roeben 1, 2 , Kathrin Brockmann 1, 2 , Johannes Streffer 4, 5 , Daniela Berg 1, 3 , Inga Liepelt-Scarfone 1, 2
Affiliation  

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 (= .02). PD‐MCI patients with an FAQQ score >1 were more impaired on tests assessing attention (= .019) and language (= .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.

中文翻译:

评估非痴呆的帕金森氏病患者的认知驱动的日常生活障碍活动。

帕金森氏病痴呆症(PDD)的核心标准是主要由认知而非运动症状引起的日常生活活动(ADL)功能受损。有证据认为,轻度认知障碍(PD-MCI)中的轻度ADL障碍是那些患有痴呆症高危患者的特征。分析了216例帕金森病(PD)患者的运动和神经心理学综合评估数据。基于线性回归模型,开发了主要反映患者的整体认知状态(FAQ C)或PD相关运动严重程度(FAQ M)的功能活动问卷(FAQ)的子评分。商(常见问题Q)计算出两个分数,> 1的值表示与运动驱动的ADL障碍相比有更多的认知能力。PD-MCI的FAQ C和FAQ M得分均高于认知正常(PD-CN)患者,表明该组的认知和运动驱动性ADL障碍更为严重。PD-MCI组中有三分之一(31.6%)的FAQ Q得分> 1,这与PD-CN患者有显着差异( =  .02)。PD-MCI患者的常见问题Q(评分> 1进行更受损上测试评估注意 =  0.019)和语言( = 相比PD-MCI患者下FAQ 0.033)Q价值观。认知和运动驱动的ADL之间的区别很重要,因为功能能力的丧失是诊断PDD的决定性因素。对于FAQ,我们能够将认知驱动的ADL障碍与运动驱动的ADL障碍区分开来。与运动驱动的ADL障碍相比,认知功能更强的PD‐MCI患者可能构成转化为PDD的危险人群,可以作为早期治疗的目标。
更新日期:2018-10-15
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