Complex Task Performance Assessment (CTPA) and Functional Cognition in People With Parkinson’s Disease

Abstract

OBJECTIVE. The objective of this study was to determine how Parkinson’s disease (PD) affects functional cognition as assessed by the Complex Task Performance Assessment (CTPA) and to examine the associations of CTPA performance with other indicators of executive function in people with PD. METHOD. Volunteers with PD without dementia (n = 20) and community control participants (n = 19) completed neuropsychological testing, patient-reported outcome measures, and the CTPA. RESULTS. There were no group differences for CTPA performance accuracy; however, the PD group took longer to complete the CTPA than did the control group. In the PD group, inefficient CTPA performance correlated with poorer cognitive flexibility and worse reported everyday shifting and task monitoring. CONCLUSION. Decreased executive function, namely cognitive flexibility and attentional control, may impair functional cognition in people with PD. Future studies with larger, more diverse samples are warranted to determine the discriminant validity and sensitivity of the CTPA. Use of performance-based assessments such as the CTPA may increase the understanding of functional cognition in people with PD.

Cognitive Correlates of Instrumental Activities of Daily Living Performance in Parkinson Disease Without Dementia

“…Reduced activity performance in the absence of neuropsychological test impairment has been observed in PD using a novel and complex work simulation activity. 46 The current study found performance limitations in more familiar and simpler tasks, which further supports the sensitivity of performance-based IADL assessment to early functional decline in PD. The longer time taken by participants with PD to complete the PASS is also consistent with studies that have used performance-based measures.…”

“…The longer time taken by participants with PD to complete the PASS is also consistent with studies that have used performance-based measures. 29 , 36 , 46 Of clinical relevance, this finding dovetails with qualitative work revealing that a major factor influencing daily function among people with PD is the increased time taken to perform daily activities. 47 Interestingly, although participants with PD perceived both physical and mental slowness in daily activities, 47 neither motor nor cognitive function were related to cognitive IADL performance time in this study.…”

“…Motor impairment was not correlated with any of the individual cognitive IADL and was not a significant independent predictor of overall cognitive IADL performance. Most existing studies have had similar results with respect to the contribution of motor function, finding no relationships with individual activities 30 , 31 , 46 or weak to moderate relationships with overall IADL performance that either do not reach significance in adjusted models or after which cognition is still an independent predictor. 27 , 29 , 34 Additionally, although depression is known to influence self-reports of daily function in PD, 6 , 20 , 21 it was not associated with cognitive IADL performance in this study or in 2 prior studies that used performance-based measures.…”

The Weekly Calendar Planning Activity to Assess Functional Cognition in Parkinson Disease

“…It appears that the PD-NC group initiated the task quickly, without planning, and then used many strategies during task performance, which supported task accuracy but increased overall time and decreased efficiency. Prior studies using performance-based tests of cognitive instrumental activities of daily living have found that PD-NC participants take more time (Davis et al, 2019; Foster, 2014) and are less efficient despite good accuracy (Davis et al, 2019). PD-NC participants may have purposefully taken longer or gone slower during the task to maintain accuracy, but using more time at the beginning to assess the task and plan out the most appropriate approach may have been more effective in terms of overall efficiency.…”

Effects of the Sn100 kVp Tube Voltage Mode on the Radiation Dose and Image Quality of Dual-Source Computed Tomography Pulmonary Angiography

“…Usually, a 120 kVp scan is recommended. [13][14][15] Low-dose scanning includes various methods, such as reducing tube current, reducing tube voltage, coarse-pitch scanning, automatic tube voltage modulation, automatic tube current modulation, and the use of noise reduction filters and iterative reconstruction algorithms. Some studies 8 suggest that the dose of radiation has a linear relationship with the tube current and an exponential relationship with the tube voltage.…”