Development and Cross-Validation of the UPSA Short Form for the Performance-Based Functional Assessment of Patients With Mild Cognitive Impairment and Alzheimer Disease

Gomar, Jesús J.; Harvey, Philip D.; Bobes-Bascaran, María Teresa; Davies, Peter; Goldberg, Terry E.

doi:10.1097/jgp.0b013e3182011846

Cited by 50 publications

(29 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We have reported that gait dysfunction is common in MCI patients in our cohort 15. Despite excluding subjects with dementia and adjusting for the cognitive status using the Blessed test, the association of gait and depressive symptoms could in part be due to presence of subjects with MCI in this sample,40 and this possibility needs to be explored in future studies 41…”

Section: Discussionmentioning

confidence: 83%

Depressive Symptoms and Gait Dysfunction in the Elderly

Brandler

Wang

Oh‐Park

et al. 2012

The American Journal of Geriatric Psychiatry

View full text Add to dashboard Cite

Objective Assess the association between depressive symptoms (not meeting the criteria for major depression) and gait dysfunction in older adults. Design Cross-sectional study. Setting Einstein Aging Study, a community-based longitudinal aging study. Participants Six hundred ten nondemented and nondepressed community-residing adults age 70 and older. Measurements Depressive symptoms measured using the 15-item Geriatric Depression Scale. To obtain a comprehensive assessment of gait, eight individual quantitative gait parameters were assessed: velocity (cm/s), stride length (cm), cadence (steps/min), swing phase (seconds), stance phase (seconds), double support phase (seconds), stride length variability (SD of stride length), and swing time variability (SD of swing time). Multiple linear regression analysis was applied to study the association of depressive symptoms with gait, adjusting for potential confounders including demographic variables, medical illnesses, and clinical gait abnormalities. Results Increased level of depressive symptoms was associated with worse velocity, stride, and swing time variability. The relationship of the remaining five gait variables with depressive symptoms was not significant in the fully adjusted models. Conclusions Higher levels of depressive symptoms are associated with worse performance in specific quantitative gait variables in community-residing older adults.

show abstract

Section: Discussionmentioning

confidence: 83%

Depressive Symptoms and Gait Dysfunction in the Elderly

Brandler

Wang

Oh‐Park

et al. 2012

The American Journal of Geriatric Psychiatry

View full text Add to dashboard Cite

show abstract

“…Performance- based measures represent a viable alternative to interview-based measures that would not require informant involvement (11). This method may be particularly attractive for screening of healthy individuals or tracking prodromal subjects over time.…”

Section: Discussionmentioning

confidence: 99%

“…Although such reports can provide valuable insight in many cases, there is evidence for caregiver bias in subjective reporting (8-10) and the psychometric reliability of these scales has been difficult to establish (2, 5). Finally, informant report measures often lack sensitivity to subtle functional deficits in non-demented preclinical and prodromal MCI/AD (11, 12). Given increasing interest in clinical trials for primary prevention and early intervention in preclinical AD, there is a growing need for measures of functional capacity with improved sensitivity to functional deficits in healthier, non-demented individuals (see (2)).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Age-Related Differences in Functional Capacity Using the Virtual Reality Functional Capacity Assessment Tool (Vrfcat)

et al. 2015

View full text Add to dashboard Cite

Clinical trials for primary prevention and early intervention in preclinical AD require measures of functional capacity with improved sensitivity to deficits in healthier, non-demented individuals. To this end, the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) was developed as a direct performance-based assessment of functional capacity that is sensitive to changes in function across multiple populations. Using a realistic virtual reality environment, the VRFCAT assesses a subject’s ability to complete instrumental activities associated with a shopping trip. The present investigation represents an initial evaluation of the VRFCAT as a potential co-primary measure of functional capacity in healthy aging and preclinical MCI/AD by examining test-retest reliability and associations with cognitive performance in healthy young and older adults. The VRFCAT was compared and contrasted with the UPSA-2-VIM, a traditional performance-based assessment utilizing physical props. Results demonstrated strong age-related differences in performance on each VRFCAT outcome measure, including total completion time, total errors, and total forced progressions. VRFCAT performance showed strong correlations with cognitive performance across both age groups. VRFCAT Total Time demonstrated good test-retest reliability (ICC=.80 in young adults; ICC=.64 in older adults) and insignificant practice effects, indicating the measure is suitable for repeated testing in healthy populations. Taken together, these results provide preliminary support for the VRFCAT as a potential measure of functionally relevant change in primary prevention and preclinical AD/MCI trials.

show abstract

“…Performance-based measures that capture changes in everyday function also represent what are thought to be clinically meaningful aspects of deterioration, which have also been shown to correlate with cognitive decline [26]. As an example, the UCSD Performance Based Skills Assessment (UPSA) measure requires subjects to perform actual proxy tasks based on real-world activities, and it appears to reveal deficits in communication and comprehension/planning domains that enable discrimination of healthy subjects, MCI patients and AD patients [27]. However, this measure may also have uncertain reliability characteristics and be culture-bound.…”

Section: Novel Approaches and Clinical Meaningfulnessmentioning

confidence: 98%

Assessing cognition and function in Alzheimer's disease clinical trials: Do we have the right tools?

Snyder

Kahle-Wrobleski

Brannan

et al. 2014

Alzheimer's & Dementia

View full text Add to dashboard Cite

Several lines of evidence from Alzheimer's disease (AD) research continue to support the notion that the biological changes associated with AD are occurring possibly several decades before an individual will experience the cognitive and functional changes associated with the disease. The National Institute on Aging-Alzheimer's Association revised criteria for AD provided a framework for this new thinking. As a result of this growing understanding, several research efforts have launched or will be launching large secondary prevention trials in AD. These and other efforts have clearly demonstrated a need for better measures of cognitive and functional change in people with the earliest changes associated with AD. Recent draft guidance from the US Food and Drug Administration further elevated the importance of cognitive and functional assessments in early stage clinical trials by proposing that even in the pre-symptomatic stages of the disease, approval will be contingent on demonstrating clinical meaningfulness. The Alzheimer's Association's Research Roundtable addressed these issues at its fall meeting October 28-29, 2013, in Washington, D.C. The focus of the discussion included the need for improved cognitive and functional outcome measures for clinical of participants with preclinical AD and those diagnosed with Mild Cognitive Impairment due to AD.

show abstract

Development and Cross-Validation of the UPSA Short Form for the Performance-Based Functional Assessment of Patients With Mild Cognitive Impairment and Alzheimer Disease

Cited by 50 publications

References 32 publications

Depressive Symptoms and Gait Dysfunction in the Elderly

Depressive Symptoms and Gait Dysfunction in the Elderly

Assessment of Age-Related Differences in Functional Capacity Using the Virtual Reality Functional Capacity Assessment Tool (Vrfcat)

Assessing cognition and function in Alzheimer's disease clinical trials: Do we have the right tools?

Contact Info

Product

Resources

About