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Assessment of cognitive‐driven activity of daily living impairment in non‐demented Parkinson's patients
Author(s) -
Becker Sara,
Bäumer Alena,
Maetzler Walter,
Nussbaum Susanne,
Timmers Maarten,
Van Nueten Luc,
Salvadore Giacomo,
Zaunbrecher Detlev,
Roeben Benjamin,
Brockmann Kathrin,
Streffer Johannes,
Berg Daniela,
LiepeltScarfone Inga
Publication year - 2020
Publication title -
journal of neuropsychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.85
H-Index - 37
eISSN - 1748-6653
pISSN - 1748-6645
DOI - 10.1111/jnp.12173
Subject(s) - activities of daily living , cognition , dementia , neuropsychology , parkinson's disease , psychology , physical medicine and rehabilitation , motor symptoms , cognitive impairment , disease , medicine , physical therapy , audiology , psychiatry
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 ( FAQ C ) or PD ‐related motor severity ( FAQ M ) were developed. A quotient ( FAQ Q ) of both scores was calculated, with values >1 indicating more cognitive‐ compared to motor‐driven ADL impairment. Both FAQ C and FAQ M 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 FAQ Q score >1, which was significantly different from patients with PD ‐ CN ( p  =   .02). PD ‐ MCI patients with an FAQ Q score >1 were more impaired on tests assessing attention ( p  =   .019) and language ( p  =   .033) compared to PD ‐ MCI patients with lower FAQ Q 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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