Cognitive Functional Abilities in Parkinson's Disease: Agreement Between Patients and Informants. Issue 6 (17th May 2019)

• Record Type: Journal Article
• Authors: Deck, Benjamin L.; Xie, Sharon X.; Choi, Gyujae; Rick, Jacqueline; Siderowf, Andrew; Rudovsky, Samuel; Chen‐Plotkin, Alice; Duda, John E.; Morley, James F.; Dahodwala, Nabila; Trojanowski, John Q.; Weintraub, Daniel
• Is Part Of: Movement disorders clinical practice. Volume 6:Issue 6(2019)
• Page Start: 440
• Page End: 445
• Publication Date: 2019-05-17
• Subjects: Parkinson's disease -- cognitive function -- activities of daily living; Movement Disorders; Movement disorders -- Periodicals; Movement disorders; Periodicals; Periodicals; 616
• DOI: 10.1002/mdc3.12781
• Languages: English
• ISSNs: 2330-1619

Abstract

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.