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

Abstract

The Weekly Calendar Planning Activity (WCPA) may improve understanding of functional cognition in people with Parkinson disease (PwPD) without dementia. We aimed to determine if WCPA performance (a) discriminates between PwPD with and without cognitive impairment and healthy controls and (b) correlates with other indicators of cognition and daily function. This was a cross-sectional study. Parkinson disease (PD) participants without dementia were divided into normal cognition (PD-NC, n = 25) and possible mild cognitive impairment (PD-MCI, n = 21) groups. Their WCPA performance was compared with that of a normative sample ( n = 196) and correlated with neuropsychological test performance and self-reported cognition and participation. Both the PD-MCI and PD-NC groups had impaired WCPA performance. WCPA performance correlated with executive function, processing speed, and self-reported cognition and participation. The WCPA can detect functional cognitive deficits in PwPD without dementia and can inform occupational therapy interventions to support functional cognition, occupational performance, and participation in this population.

Translation, cross-cultural adaptation and validation of the 10-item Weekly Calendar Planning Activity in Spanish-speaking ABI patients: a multicenter study

“…This is in line with prior studies on the WCPA with other neurological conditions like multiple sclerosis (Goverover et al, 2020), and adolescents with ABI (Doherty et al, 2022), which have also found a significant relationship between accurate performance and strategy use in WCPA and established measures of EF. Furthermore, the relationship between the total accuracy score and neuropsychological tests that measure EF has also been observed in studies with Parkinson's patients (Foster et al, 2022). These findings support prior work highlighting the role of EF for successful everyday activity completion (Poncet et al, 2017;Lipskaya-Velikovsky et al, 2018).…”

Methodological Issues in Advancing the Status of Functional Cognitive Assessment

“…Assessments of neurocognitive skills support the understanding of performance, but is not a substitute for performance-based testing of functional cognition. When neurocognitive measures and functional cognitive measures are administered together, correlations rarely exceed the moderate range suggesting that they are indeed measuring disparate constructs (Boone & Wolf, 2021; Foster et al, 2022). We are not arguing against the importance of neurocognitive assessment.…”

“…We recommend that functional cognitive and neurocognitive measures be used in tandem to create a comprehensive understanding of cognitive function. There is ample evidence supporting a multi-level approach that combines neurocognitive data with functional data to improve identification of individuals with both cognitive impairment and functional cognitive deficits (Dham et al, 2020; Foster et al, 2022; Gonzalez et al, 2021). However, the use of brief global screening measures (e.g., Mini Mental State Exam, the Montreal Cognitive Assessment [MOCA], and the Neurobehavioral Cognitive Status Examination; Folstein et al, 1975; Kiernan et al, 1987; Nasreddine et al, 2005) to infer real-world IADL performance capacity is beyond the scope of the original purpose of the measures (Burgess et al, 2006).…”

“…What is most important for measures of functional cognition is the convergence between performance on the specific simulated IADL tests and the ability to perform necessary IADLs or functions in the individual’s daily life. Thus, predictive validity is essential in the development performance-based testing of functional cognition (Foster et al, 2022). Another issue to consider is the degree to which performance-based tests of functional cognition should include correction for demographic variables.…”

Validity of the Short Weekly Calendar Planning Activity in patients with Parkinson disease and nonmanifesting LRRK2 and GBA carriers

“…The WCPA is a multistep activity of scheduling a list of appointments into a weekly schedule that requires working memory, planning, shifting, inhibition, and self-monitoring [23]. The 17-item version of the WCPA differentiated between healthy controls (HCs) and individuals (known-group validity) with multiple sclerosis (MS) [24] and PD with a mean duration of 6.7 years from diagnosis [25]. The WCPA's convergent and ecological validity has also been established specifically for MS [24].…”