Benjamin L Deck1,2, Sharon X Xie3, Gyujae Choi4, Jacqueline Rick1, Andrew Siderowf1, Samuel Rudovsky1, Alice Chen-Plotkin1, John E Duda1,5, James F Morley1,5, Nabila Dahodwala1, John Q Trojanowski6, Daniel Weintraub1,7,5. 1. Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA. 2. Department of Psychology Drexel University Philadelphia Pennsylvania USA. 3. Departments of Biostatistics, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA. 4. Department of Radiation Oncology Baylor College of Medicine Houston Texas USA. 5. Michael J. Crescenz Veterans Affairs Medical Center, Parkinson's Disease Research Education and Clinical Center (PADRECC) Philadelphia Pennsylvania USA. 6. Departments of Pathology and Laboratory Medicine, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA. 7. Departments of Psychiatry, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.
Abstract
BACKGROUND: The Penn Parkinson's Daily Activities Questionnaire-15 (PDAQ-15) assesses cognition-related instrumental activities of daily living (IADL) in Parkinson's disease (PD). OBJECTIVES: To assess the degree and predictors of disagreement between patients (PT) and knowledgeable informants (KI) on the PDAQ-15. METHODS: We recruited 254 PT and KI pairs (PT-KI), determined predictors of agreement, and compared scores to a performance-based functional measure (Direct Assessment of Functional Status [DAFS]; N = 61). RESULTS: PT and KI total score (intraclass correlation = 0.57) and individual item (Cohen's kappa = 0.46-0.62) agreement were moderate. Patient depression, global cognition, and caregiver burden (all P < 0.05), predicted PT-KI discrepancy. PT-KI discrepancy was highest in patients with a dementia diagnosis, followed by mild cognitive impairment and then normal cognition (all P < 0.01), with PT rating themselves relatively more functionally intact as cognition worsened. DAFS performance was more highly correlated with KI (r = 0.82; P < 0.001) than PT (r = 0.62; P < 0.001) PDAQ-15 score. CONCLUSIONS: Our results support using KI as proxies when assessing cognitive IADLs in PD PTs, particularly in cases of more advanced cognitive decline.
BACKGROUND: The Penn Parkinson's Daily Activities Questionnaire-15 (PDAQ-15) assesses cognition-related instrumental activities of daily living (IADL) in Parkinson's disease (PD). OBJECTIVES: To assess the degree and predictors of disagreement between patients (PT) and knowledgeable informants (KI) on the PDAQ-15. METHODS: We recruited 254 PT and KI pairs (PT-KI), determined predictors of agreement, and compared scores to a performance-based functional measure (Direct Assessment of Functional Status [DAFS]; N = 61). RESULTS: PT and KI total score (intraclass correlation = 0.57) and individual item (Cohen's kappa = 0.46-0.62) agreement were moderate. Patient depression, global cognition, and caregiver burden (all P < 0.05), predicted PT-KI discrepancy. PT-KI discrepancy was highest in patients with a dementia diagnosis, followed by mild cognitive impairment and then normal cognition (all P < 0.01), with PT rating themselves relatively more functionally intact as cognition worsened. DAFS performance was more highly correlated with KI (r = 0.82; P < 0.001) than PT (r = 0.62; P < 0.001) PDAQ-15 score. CONCLUSIONS: Our results support using KI as proxies when assessing cognitive IADLs in PD PTs, particularly in cases of more advanced cognitive decline.
Entities:
Keywords:
Parkinson's disease; activities of daily living; cognitive function
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