Objective Cognitive-driven activity of daily living (ADL) impairment in Parkinson’s disease (PD) is increasingly discussed as prodromal marker for dementia. Diagnostic properties of assessments for this specific ADL impairment are sparsely investigated in PD. The ability of the Functional Activities Questionnaire (FAQ) for differentiating between PD patients with normal cognition and with mild cognitive impairment (PD-MCI), according to informant and self-reports, was examined. Global cognitive function in groups with and without mild ADL impairment was compared according to different cut-offs. Methods Multicenter data of 589 patients of an international cohort (CENTRE-PD) were analyzed. Analyses were run separately for informant-rated and self-rated FAQ. Receiver operating characteristic (ROC) analysis was conducted to define the optimal FAQ cut-off for PD-MCI (≥ 1), and groups were additionally split according to reported FAQ cut-offs for PD-MCI in the literature (≥ 3, ≥ 5). Binary logistic regressions examined the effect of the Montreal Cognitive Assessment (MoCA) score in PD patients with and without mild ADL impairment. Results Two hundred and twenty-five (38.2%) patients were classified as PD-MCI. For all three cut-off values, sensitivity was moderate to low (< 0.55), but specificity was moderately high (> 0.54) with a tendency of higher values for self-reported deficits. For the self-report, the cut-off ≥ 3 showed a significant effect of the MoCA (B = − 0.31, p = 0.003), where FAQ ≥ 3 patients had worse cognition. No effect for group differences based on informant ratings was detected. Conclusion Our data argue that self-reported ADL impairments assessed by the FAQ show a relation to the severity of cognitive impairment in PD.
Bibliographical noteFunding Information:
Open Access funding enabled and organized by Projekt DEAL. This project was funded within the European Union’s Horizon 2020 research and innovation program under grant agreement No. 692320 (WIDESPREAD; CENTRE-PD). This work was supported by a grant from the Luxembourg National Research Fund (Fonds National de Recherche, FNR - FNR/NCER13/BM/11264123) within the National Centre of Excellence in Research on Parkinson’s disease (NCER-PD), the Parkinson’s UK Monument Award to the Oxford Parkinson’s Disease Centre, and the Oxford Biomedical Research Centre.
© 2021, The Author(s).
- cognitive dysfunction
- cohort studies
- mild cognitive impairment
- neuropsychological tests