Validation of a performance-based assessment of cognitive functional ability in Parkinson's disease

Samantha K. Holden*, Luis D. Medina, Brian Hoyt, Stefan H. Sillau, Brian D. Berman, Jennifer G Goldman, Daniel Weintraub, Benzi M. Kluger

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Outcome measures that capture functional abilities related to cognition offer the potential to demonstrate real-world effectiveness of cognitive-enhancing treatments. However, distinguishing functional disability related to cognition from that attributed to motor symptoms can be difficult in PD. A performance-based functional assessment allows for direct observation of activity of daily living skills and separation of cognitive from motoric disabilities. Objectives: Validate the University of California San Diego Performance-Based Skills Assessment in PD. Methods: One hundred PD participants, ranging from normal cognition to dementia, completed the University of California San Diego Performance-Based Skills Assessment, a performance-based measure of cognitively demanding activities of daily living, as well as a neuropsychological battery and motor examination. Cognitive classification was determined by consensus conference, blinded to University of California San Diego Performance-Based Skills Assessment scores. Psychometric properties of the University of California San Diego Performance-Based Skills Assessment, including internal consistency, test-retest and inter-rater reliability, and discriminant validity for dementia, were examined. Results: The University of California San Diego Performance-Based Skills Assessment demonstrated strong internal consistency (Cronbach's α = 0.82) and test-retest reliability (r = 0.89) and correlated strongly with global cognition (Mattis Dementia Rating Scale: r = 0.80; P < 0.001). University of California San Diego Performance-Based Skills Assessment regression models indicated greater contribution from cognitive explanatory variables (marginal partial: R2 = 0.33) than motor variables (marginal partial: R2 = 0.05), controlling for age, education, disease duration, and l-dopa equivalent dose. Additionally, the University of California San Diego Performance-Based Skills Assessment exhibited strong discriminant validity for dementia (area under the curve = 0.91). Conclusions: The University of California San Diego Performance-Based Skills Assessment is a valid measure of functional abilities related to cognition rather than motor symptoms in PD. Furthermore, it reliably distinguishes demented from nondemented participants. The University of California San Diego Performance-Based Skills Assessment may be considered as an outcome measure that combines cognitive and functional abilities in treatment trials for cognitive impairment in PD.

Original languageEnglish (US)
Pages (from-to)1760-1768
Number of pages9
JournalMovement Disorders
Volume33
Issue number11
DOIs
StatePublished - Nov 2018

Keywords

  • Parkinson's disease
  • dementia
  • functional assessment
  • mild cognitive impairment
  • outcome measures

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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  • Cite this

    Holden, S. K., Medina, L. D., Hoyt, B., Sillau, S. H., Berman, B. D., Goldman, J. G., Weintraub, D., & Kluger, B. M. (2018). Validation of a performance-based assessment of cognitive functional ability in Parkinson's disease. Movement Disorders, 33(11), 1760-1768. https://doi.org/10.1002/mds.27487