Staging of cognitive impairment in Parkinson’s disease: validity of Quick Dementia Rating System

Asl, Aysan Mahmoudi; Mehdizadeh, Maryam; Roudbari, Parvin Raeesi; Mehdizadeh, Hajar; Habibi, Seyed-Amirhasan; Khatoon, Javad Niazi; Taghizadeh, Ghorban

doi:10.1080/09638288.2020.1755728

Cited by 10 publications

(5 citation statements)

References 27 publications

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“…[20] Cognitive impairment in PD is characterized by predominant executive deficits, visuospatial dysfunction, and relatively affected memory. [21] Natural products have definitive molecular or pharmacological effects that are prone to contribute to the development of neuroprotective agents against PD. [6] Glutamate-mediated excitotoxicity may be elaborated in a dangerous vicious cycle, which crucially contributes to the exacerbation of nigrostriatal degeneration in PD.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2023

IJGP

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Background: Parkinson's disease (PD) caused due to neuroinflammation and oxidative stress associated with motor and non-motor complications. Neuroprotection strategies create a hope for patients. Natural products have been increasing the gain to have specific molecular or pharmacological activities that are likely to supply the development of neuroprotective agents against PD. Cissus quadrangularis constitutes all suitable physical and chemical properties and its ability to cross the blood-brain barrier making it a relevant candidate for the treatment of neuroprotection in PD. Materials and Methods: The stem part of the plant was extracted with distilled water and ethanol. The antiparkinson's activity of both extracts of C. quadrangularis was evaluated using rotenoneinduced excitotoxicity model in zebrafish for 96 h resulting in alterations in swimming pattern measured through a video recording system. Further, cognitive improvement activity in PD of both extracts of plant was evaluated using reserpine-induced cognitive impairments in mice for 29 days. Biochemical parameters, that is, levels of catalase and glutathione (GSH) were analyzed using UV-visible spectrophotometer. Results: The aqueous extract of C. quadrangularis (AECQ) showed a significant and dose-dependent effect against rotenone-induced PD in adult zebrafish's at a dose of 4 and 10 µg/mL and cognitive improvement activity against reserpine-induced cognitive impairment in mice at a dose of 200 mg/kg and 500 mg/kg. The AECQ also showed a significant in vivo antioxidant potential by restoring the levels of catalase and GSH. The results of the present study demonstrate the potential antiparkinson's properties of the aqueous extract. Conclusion: The result of the present study conclusively shows the Anti-Parkinson's activity of C. quadrangularis and improved cognition in PD.

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Section: Discussionmentioning

confidence: 99%

Untitled

2023

IJGP

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“…(1) memory and recall, (2) orientation, (3) decision-making and problem-solving abilities, (4) activities outside the home, (5) function at home and performing hobbies, (6) toileting and personal hygiene, (7) behavior and personality, (8) language and communication abilities, (9) mood, and ( 10) attention and concentration. The QDRS contains two subscales: a cognitive subscale (questions 1, 2, 3, and 8) and a functional subscale (questions 4, 5, 6, 7, 9, and 10).…”

Section: Cognitive Impairment Screenersmentioning

confidence: 99%

“…The QDRS scores range from 0 to 30, with a higher score indicating a more severe degree of perceived cognitive impairment. 10 The cutoff for the score ranges are: normal (0-1), mild CI (2-5), mild dementia (6)(7)(8)(9)(10)(11)(12), moderate dementia (13)(14)(15)(16)(17)(18)(19)(20), and severe dementia (20-30).…”

Section: Cognitive Impairment Screenersmentioning

confidence: 99%

“…One such tool is the Quick Dementia Rating Scale (QDRS), a self or informantreport of perceived cognitive, functional, and behavioral status that aids with staging of CI as mild, moderate, or severe. 9 The QDRS was first developed and validated against other well-studied neuropsychological tests of cognitive function, mood, and behavior in a population of patient-caregiver pairs seeking care for memory disorders. 10 However, to date, the QDRS has not been used to screen CI among LT.…”

Section: Introductionmentioning

confidence: 99%

“…The ideal initial screening for CI in this population could be quickly and easily administered, be completed remotely (e.g., before clinic visits or during telemedicine visits), and be completed by a caregiver if the recipient's impairment limits participation. One such tool is the Quick Dementia Rating Scale (QDRS), a self or informant‐report of perceived cognitive, functional, and behavioral status that aids with staging of CI as mild, moderate, or severe 9 . The QDRS was first developed and validated against other well‐studied neuropsychological tests of cognitive function, mood, and behavior in a population of patient‐caregiver pairs seeking care for memory disorders 10 .…”

Section: Introductionmentioning

confidence: 99%

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A pragmatic tool to screen for pre‐transplant cognitive impairment among potential candidates for liver transplant

Teles,

Ruck,

Jefferis

et al. 2024

Clinical Transplantation

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IntroductionCognitive impairment (CI) among liver transplant (LT) candidates is associated with increased risk of waitlist mortality and inferior outcomes. While formal neurocognitive evaluation is the gold standard for CI diagnosis, the Montreal Cognitive Assessment (MoCA) is often used for first‐line cognitive screening. However, MoCA requires specialized training and may be too lengthy for a busy evaluation appointment. An alternate approach may be the Quick Dementia Rating System (QDRS), which is patient‐ and informant‐based and can be administered quickly. We compared potential LT candidates identified by MoCA and QDRS as potentially benefiting from further formal cognitive evaluation.MethodsWe identified 46 potential LT candidates enrolled at a single center of a prospective, observational cohort study who were administered MoCA and QDRS during transplant evaluation (12/2021–12/2022). Scores were dichotomized as (1) normal versus abnormal and (2) normal/mild impairment versus more‐than‐mild impairment. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of QDRS compared to MoCA.ResultsBy MoCA, this population had a prevalence of 48% normal cognition, 48% mild, 4% moderate, and 0% severe impairment. This was categorized as 96% normal/mild and 4% more‐than‐mild impairment. When comparing to MoCA cognitive screening, QDRS had a sensitivity of 61%, specificity of 56%, NPV of 56%, and PPV of 61%. When identifying more‐than‐mild impairment, QDRS had a sensitivity of 100%, specificity of 73%, NPV of 100%, and PPV of 10%.ConclusionThe high sensitivity and NPV of QDRS in identifying more‐than‐mild impairment suggests it could identify potential LT candidates who would benefit from further formal cognitive evaluation. The ability to administer QDRS quickly and remotely makes it a pragmatic option for pre‐transplant screening.

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Performance of study partner reports in a non‐demented at‐risk sample

Huang,

Bolt,

Jonaitis

et al. 2024

Alzheimer's & Dementia

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INTRODUCTIONThe Clinical Dementia Rating (CDR) Scale is a gold standard for staging impairment in Alzheimer's disease and other dementias (ADRD). The Quick Dementia Rating System (QDRS) offers similar results in 3 to 5 minutes without a trained clinician. This study aimed to (1) investigate concordance between comparably derived QDRS and CDR global scores, (2) examine item‐level QDRS/CDR agreement, and (3) compare sample characteristics and cognitive performance across QDRS/CDR global concordant/discordant groups.METHODSThe study included 351 QDRS/CDR pairs from 297 participants in the Wisconsin Registry for Alzheimer's Prevention (WRAP). Analyses included descriptive indices of QDRS/CDR agreement, lasso logistic regression, tetrachoric correlations, and linear mixed models.RESULTSThe QDRS global/CDR global concordance rate is 70.66%. Memory item discrepancies were primarily responsible for QDRS/CDR global rating discordance. Average cognitive scores were highest in concordant‐normal QDRS/CDR and lowest in concordant‐abnormal QDRS/CDR.DISCUSSIONThe QDRS effectively screened for impairment in this sample. Future analyses will investigate QDRS relations to ADRD biomarkers.Highlights The Quick Dementia Rating System (QDRS) effectively screened for impairment in Alzheimer's disease and other dementias (ADRD) in a non‐demented sample. Concordance rate between QDRSCDR global and Clinical Dementia Rating (CDR) Scale global scores is 70.66%. Memory item discrepancies primarily cause QDRS/CDR global score discordance. Cognitive scores are associated with QDRS/CDR concordances/discordances. Future analyses will explore QDRS relations to ADRD biomarkers.

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Staging of cognitive impairment in Parkinson’s disease: validity of Quick Dementia Rating System

Cited by 10 publications

References 27 publications

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Untitled

A pragmatic tool to screen for pre‐transplant cognitive impairment among potential candidates for liver transplant

Performance of study partner reports in a non‐demented at‐risk sample

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