Modified Pfeffer Questionnaire for Functional Assessment in Parkinson Disease

Almeida, Kelson James; Macêdo, Lívio Pereira de; Lopes, José Gabriel; Bor‐Seng‐Shu, Edson; Campos-Sousa, Raimundo Nonato; Barbosa, Egberto Reis

doi:10.1177/0891988717720298

Cited by 9 publications

(11 citation statements)

References 33 publications

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“…For this approach, we used the FAQ, which was divided into two subscores, the FAQ C and the FAQ M , to differentiate cognitive-and motor-driven aspects of ADL function. Contrary to the approach by Almeida et al (2017), we chose to include all FAQ items in our analyses and separate the cognitive and motor contributions using a data-driven analysis. Their approach was theory-driven by validating their modified FAQ and its cut-off using a separate, informant-based questionnaire assessing ADL impairment changes over 2 years, instead of using motor and cognitive scales as validation.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of cognitive‐driven activity of daily living impairment in non‐demented Parkinson's patients

Becker

Bäumer

Maetzler

et al. 2018

Journal of Neuropsychology

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The core criterion for Parkinson's disease dementia (PDD) is the impairment in activities of daily living (ADL) function primarily caused by cognitive, not motor symptoms. There is evidence to assume that mild ADL impairments in mild cognitive impairment (PD‐MCI) characterize those patients at high risk for dementia. Data of 216 Parkinson's disease (PD) patients assessed with comprehensive motor and neuropsychological assessments were analysed. Based on linear regression models, subscores of the Functional Activities Questionnaire (FAQ) primarily reflecting patients’ global cognitive status (FAQC) or PD‐related motor severity (FAQM) were developed. A quotient (FAQQ) of both scores was calculated, with values >1 indicating more cognitive‐ compared to motor‐driven ADL impairment. Both FAQC and FAQM scores were higher in PD‐MCI than cognitively normal (PD‐CN) patients, indicating more severe cognitive‐ and motor‐driven ADL impairments in this group. One third (31.6%) of the PD‐MCI group had a FAQQ score >1, which was significantly different from patients with PD‐CN (p = .02). PD‐MCI patients with an FAQQ score >1 were more impaired on tests assessing attention (p = .019) and language (p = .033) compared to PD‐MCI patients with lower FAQQ values. The differentiation between cognitive‐ and motor‐driven ADL is important, as the loss of functional capacity is the defining factor for a diagnosis of PDD. We were able to differentiate the cognitive‐driven from the motor‐driven ADL impairments for the FAQ. PD‐MCI patients with more cognitive‐ compared to motor‐driven ADL impairments may pose a risk group for conversion to PDD and can be targeted for early treatments.

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Section: Discussionmentioning

confidence: 99%

“…In a recent paper, Almeida et al . () modified the Pfeffer Functional Activities Questionnaire (FAQ), a validated assessment for ADL impairment, to exclude some questions which might pertain to motor skills. Their data confirmed that the FAQ is a valid measure for functional impairment in PD.…”

Section: Introductionmentioning

confidence: 99%

Assessment of cognitive‐driven activity of daily living impairment in non‐demented Parkinson's patients

Becker

Bäumer

Maetzler

et al. 2018

Journal of Neuropsychology

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“…Corroborando com esses dados, dois estudos brasileiros sugeriram que o questionário da pílula é menos sensível do que outros instrumentos para detectar comprometimento funcional 15,33 . Estudos prévios avaliando pacientes brasileiros com DDP utilizaram alguns instrumentos para avaliar habilidades funcionais, incluindo o questionário de atividades funcionais de Pfeffer, Avaliação de Incapacidade em Demência (DAD), Questionário de Informante sobre Declínio Cognitivo em Idosos (IQCODE), Pill Questionnaire, teste de telefone e Avaliação Direta da Capacidade Funcional (DAFA) 15,[33][34][35][36][37] . Dois estudos avaliaram a precisão do Pfeffer para detectar comprometimento funcional em pacientes com DP 33,37 .…”

Section: Caraterísticas Clínicas Principaisunclassified

“…Estudos prévios avaliando pacientes brasileiros com DDP utilizaram alguns instrumentos para avaliar habilidades funcionais, incluindo o questionário de atividades funcionais de Pfeffer, Avaliação de Incapacidade em Demência (DAD), Questionário de Informante sobre Declínio Cognitivo em Idosos (IQCODE), Pill Questionnaire, teste de telefone e Avaliação Direta da Capacidade Funcional (DAFA) 15,[33][34][35][36][37] . Dois estudos avaliaram a precisão do Pfeffer para detectar comprometimento funcional em pacientes com DP 33,37 . Oliveira et al propôs que pontuação maior que dois pontos na escala de Pfeffer tinha uma sensibilidade de 23% e uma especificidade de 74% para predizer desempenho anormal em um teste cognitivo global 33 .…”

Section: Caraterísticas Clínicas Principaisunclassified

“…Em contrapartida, um estudo prévio de Almeida et al definiu uma pontuação superior a três como o melhor ponto de corte para uma versão modificada do Pfeffer (mPfeffer) para diagnosticar DDP (sensibilidade de 47% e especificidade de 88%). Nessa versão modificada, os autores suprimiram os itens 5 (fazer um café) e 6 (preparar uma refeição) da forma original, para minimizar os possíveis efeitos dos sintomas motores que afetam a interpretação da avaliação da funcionalidade do paciente 37 . Neste mesmo estudo, os autores utilizaram o IQCODE como referência para diagnosticar o comprometimento funcional e utilizaram o escore de corte de 3,27, o mesmo definido pela adaptação transcultural da escala de avaliação de incapacidade em demência para pacientes brasileiros com demência da DA 37 .…”

Section: Caraterísticas Clínicas Principaisunclassified

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Diagnóstico e manejo da demência da doença de Parkinson e demência com corpos de Lewy: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia

Parmera

Tumas

Ferraz

et al. 2022

Dement. neuropsychol.

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RESUMO A demência da doença de Parkinson (DDP) e a demência com corpos de Lewy (DCL) representam a segunda causa mais comum de demência neurodegenerativa em pessoas com mais de 65 anos, ocasionando progressivo declínio cognitivo e comprometimento da qualidade de vida. O presente estudo tem como objetivo prover um consenso de especialistas sobre a DDP e DCL, baseado em revisão sistemática da literatura brasileira e revisão não-sistemática de literatura internacional. Ademais, tal estudo visa promover informação e conceder recomendações sobre abordagem diagnóstica, com foco nos níveis de atenção primária e secundária em saúde. Com base nos dados disponíveis, recomendamos que os profissionais realizem pelo menos um breve instrumento cognitivo global, como o Mini-Exame do Estado Mental, contudo de preferência optem pela Avaliação Cognitiva de Montreal e o Exame Cognitivo de Addenbrooke-Revisado. Observa-se uma carência de instrumentos validados para a avaliação precisa das habilidades funcionais em pacientes brasileiros com DDP e DCL. Além disso, mais estudos focando em biomarcadores com coortes brasileiras também são necessários.

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Cognition and Activity of Daily Living Function in people with Parkinson’s disease

Bode,

Kalbe,

Liepelt-Scarfone

2024

J Neural Transm

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The ability to perform activities of daily living (ADL) function is a multifaceted construct that reflects functionality in different daily life situations. The loss of ADL function due to cognitive impairment is the core feature for the diagnosis of Parkinson’s disease dementia (PDD). In contrast to Alzheimer’s disease, ADL impairment in PD can be compromised by various factors, including motor and non-motor aspects. This narrative review summarizes the current state of knowledge on the association of cognition and ADL function in people with PD and introduces the concept of “cognitive ADL” impairment for those problems in everyday life that are associated with cognitive deterioration as their primary cause. Assessment of cognitive ADL impairment is challenging because self-ratings, informant-ratings, and performance-based assessments seldomly differentiate between “cognitive” and “motor” aspects of ADL. ADL function in PD is related to multiple cognitive domains, with attention, executive function, and memory being particularly relevant. Cognitive ADL impairment is characterized by behavioral anomalies such as trial-and-error behavior or task step omissions, and is associated with lower engagement in everyday behaviors, as suggested by physical activity levels and prolonged sedentary behavior. First evidence shows that physical and multi-domain interventions may improve ADL function, in general, but the evidence is confounded by motor aspects. Large multicenter randomized controlled trials with cognitive ADL function as primary outcome are needed to investigate which pharmacological and non-pharmacological interventions can effectively prevent or delay deterioration of cognitive ADL function, and ultimately the progression and conversion to PDD.

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Modified Pfeffer Questionnaire for Functional Assessment in Parkinson Disease

Abstract: 3.5 is proposed as the cutoff point to define functional impairment in patients with PD by mPQ.

Cited by 9 publications

References 33 publications

Assessment of cognitive‐driven activity of daily living impairment in non‐demented Parkinson's patients

Assessment of cognitive‐driven activity of daily living impairment in non‐demented Parkinson's patients

Diagnóstico e manejo da demência da doença de Parkinson e demência com corpos de Lewy: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia

Cognition and Activity of Daily Living Function in people with Parkinson’s disease

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