Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research , Tübingen, Germany.
Intergrated Care and Research Unit, German Center for Neurodegenerative Diseases (DZNE) , Tübingen, Germany.
J Clin Exp Neuropsychol. 2020 Oct;42(8):867-879. doi: 10.1080/13803395.2020.1825634. Epub 2020 Oct 12.
In Parkinson's disease (PD), activities of daily living (ADL) impairments are crucial for diagnosis of dementia (PDD). Performance-based tests are promising tools to discriminate between different levels of cognitive impairment in PD; however, the value of those tests for diagnosis of PDD is only sparsely investigated. Therefore, we evaluated the Erlangen Test of Activities of Daily Living (E-ADL), a time-efficient performance-based ADL test, in PD.
In this cross-sectional study, 40 PD patients with normal cognition (PD-NC), 45 patients with mild cognitive impairment (PD-MCI) and 21 patients with PDD were assessed with a comprehensive ADL and cognitive test battery.
Interrater reliability (=.86) indicated high consistency of the standardized E-ADL scoring system between raters. The E-ADL correlated significantly with other tests of ADL functions ( <.01), highest with an alternative performance-based ADL test (= -.52), and lowest with self-ratings and a physician-rated scale. The E-ADL was also associated with cognitive impairment ( <.01), but also with motor impairment. A binary logistic regression model verified that the E-ADL ( =.04) was an independent predictor of PDD, in addition to motor impairment explaining 53.3% of variance. Receiver operating characteristic curve analysis of the E-ADL revealed an area under the curve of 0.78, a specificity of 77%, and a sensitivity of 67% for diagnosis PDD.
The standardized, easy, and quick to administer E-ADL showed acceptable levels of reliability, and validity in PD and measures cognitive-driven ADL functions. Therefore, it might be a suitable test to support diagnosis of PDD in the clinical daily routine.
在帕金森病（PD）中，日常生活活动（ADL）受损对于痴呆（PDD）的诊断至关重要。基于表现的测试是区分 PD 不同认知损伤程度的有前途的工具；然而，这些测试用于诊断 PDD 的价值仅得到了稀疏的研究。因此，我们评估了一种时间效率高的基于表现的 ADL 测试——埃尔朗根日常生活活动测试（E-ADL）在 PD 中的应用。
在这项横断面研究中，我们评估了 40 名认知正常的 PD 患者（PD-NC）、45 名轻度认知障碍患者（PD-MCI）和 21 名 PDD 患者，使用综合 ADL 和认知测试组合进行评估。
评分者间的信度（=.86）表明，标准化的 E-ADL 评分系统具有很高的一致性。E-ADL 与其他 ADL 功能测试显著相关（<.01），与替代基于表现的 ADL 测试相关性最高（= -.52），与自我评估和医生评定量表相关性最低。E-ADL 也与认知障碍相关（<.01），但也与运动障碍相关。二元逻辑回归模型验证了 E-ADL（=.04）是 PDD 的独立预测因子，除了运动障碍解释了 53.3%的方差。E-ADL 的受试者工作特征曲线分析显示，曲线下面积为 0.78，对 PDD 的特异性为 77%，敏感性为 67%。
标准化、易于操作和快速实施的 E-ADL 在 PD 中具有可接受的信度和效度，并且可以测量认知驱动的 ADL 功能。因此，它可能是支持临床日常实践中 PDD 诊断的合适测试。
