Psychometric properties of the Autonomic Symptoms Checklist in the Lewy body disease module of the uniform dataset. (15th November 2022)

• Record Type: Journal Article
• Authors: Waters, Abigail B.; Williamson, John B.; Kiselica, Andrew M.
• Is Part Of: International journal of geriatric psychiatry. Volume 37:Number 12(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-11-15
• Subjects: autonomic symptoms -- Lewy body -- psychometrics -- reliability -- validity; Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.5838
• Languages: English
• ISSNs: 0885-6230

Abstract

Abstract: Introduction: Autonomic dysfunction is an important feature of Lewy Body Dementia (DLB), but measurement of autonomic symptoms has been limited in both previous research and clinical practice. Accurate measurement of autonomic dysfunction has the potential to improve our understanding of the course and progression of DLB, given that autonomic symptoms typically precede cognitive impairment and are associated with functional impairment. The primary aim of this study was to examine the psychometric properties of the two versions (3.0 and 3.1) of the NACC LBD‐module Autonomic Symptom Checklist (ASC). Methods: Psychometric analyses of the ASC (internal consistency, reliability, factor structure, and validity) were conducted on data acquired from 245 individuals with DLB from the NACC database. ASC V3.0 was contrasted on these attributes to V3.1. Results: Results suggested an underlying factor structure for the ASC, and confirmatory factor analysis (CFA) revealed 3 factors, which generally aligned with discrete autonomic systems. The ASC V3.0 and CFA‐identified scales were comparable in terms of reliability, which were both improved relative to the ASC V3.1. In terms of ecological validity, CFA‐identified items related to gastrointestinal/thermoregulation symptoms were significantly more associated with functional outcomes compared to the unitary ASC. Conclusion: Findings underscore the importance of differentiation within the autonomic system. Future research into autonomic symptom classes and lab‐based pathophysiological measurement of autonomic dysfunction in DLB has the potential to support early identification and inform treatment planning. Key Points: First study of the psychometric properties of the Autonomic Symptoms Checklist (ASC). ASC has generally acceptable reliability. Factor analysis supports interpretation of autonomic dysfunction as multidimensional. Enteric system symptoms are most associated with functional outcomes.