Extended Timed Up and Go assessment as a clinical indicator of cognitive state in Parkinson's disease

JOURNAL OF THE NEUROLOGICAL SCIENCES

卷:375

Article

Evans, Tess¹  Jefferson, Alexa²  Byrnes, Michelle^2,3  Walters, Sue^2,3  Ghosh, Soumya^2,3  Mastaglia, Frank L.^2,3,4  Power, Brian¹  Anderton, Ryan S.^2,3,5 

[1] Univ Notre Dame Australia, Sch Med, Fremantle, WA, Australia

[2] Western Australian Neurosci Res Inst, QEII Med Ctr, A Block, Nedlands, WA, Australia

[3] Univ Western Australia, Ctr Neuromuscular & Neurol Disorders, Nedlands, WA, Australia

[4] Murdoch Univ, Inst Immunol & Infect Dis, Perth, WA, Australia

[5] Univ Notre Dame Australia, Sch Hlth Sci, Fremantle, WA, Australia

关键词: Parkinson's disease;    Cognitive state;    Timed Up and Go;    SCOPA;   

DOI  :  10.1016/j.jns.2017.01.050

来源: Elsevier

【 摘 要 】

Objective: To evaluate a modified extended Timed Up and Go (extended-TUG) assessment against a panel of validated clinical assessments, as an indicator of Parkinson's disease (PD) severity and cognitive impairment. Methods: Eighty-seven participants with idiopathic PD were sequentially recruited from a Movement Disorders Clinic. An extended-TUG assessment was employed which required participants to stand from a seated position, walk in a straight line for 7 m, turn 180 and then return to the start, in a seated position. The extended-TUG assessment duration was correlated to a panel of clinical assessments, including the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Quality of Life (PDQ-39), Scales for Outcomes in Parkinson's Disease (SCOPA-Cog), revised Addenbrooke's Cognitive Index (ACE-R) and Barratt's Impulsivity Scale 11 (BIS-11). Results: Extended-TUG time was significantly correlated to MDS-UPDRS III score and to SCOPA-Cog, ACE-R (p < 0.001) and PDQ-39 scores (p < 0.01). Generalized linear models determined the extended-TUG to be a sole variable in predicting ACE-R or SCOPA-Cog scores. Patients in the fastest extended-TUG tertile were predicted to perform 8.3 and 13.4 points better in the SCOPA-Cog and ACE-R assessments, respectively, than the slowest group. Patients who exceeded the dementia cut-off scores with these instruments exhibited significantly longer extended-TUG times. Conclusions: Extended-TUG performance appears to be a useful indicator of cognition as well as motor function and quality of life in PD, and warrants further evaluation as a first line assessment tool to monitor disease severity and response to treatment. Poor extended-TUG performance may identify patients without overt cognitive impairment form whom cognitive assessment is needed. (C) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

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