Longitudinal Study of a Novel, Performance-based Measure of Everyday Functional Competence.

摘要

As the Alzheimer s disease field moves to studies and intervention trials in the preclinical phase and early prodromal period, it will be necessary to measure everyday function in an increasingly more sensitive and sophisticated way to capture more subtle impairments. One approach to increasing sensitivity in functional measures is to use performance based instruments, such as the UCSD Performance-based Skills Assessment (UPSA), in Mild Cognitive Impairment (MCI) or mild Alzheimer s disease (AD) research. In this test patients are observed and their response scored as they actually perform proxies for real world tasks and it contrasts with more typical informant based measures. In a preliminary study we compared patients with MCI, patients with mild AD, and healthy age matched controls on the UPSA. We found that patients with MCI had compromises in everyday functional competence and that the UPSA was strikingly sensitive to these (Goldberg et al, 2010). However, that study was not longitudinal. Therefore, it is important that we obtain data on the longitudinal characteristics of the UPSA. Over the past year we have enrolled 25 subjects into our protocol. Of these 24 received the six week follow up. Another 26 subjects received the one year follow up. Our total number of enrolled subjects is 48. Preliminary results demonstrated 1. highly significant differences between the diagnostic groups (healthy control (HC), Mild Cognitive Impairment (MCI), AD) such that the HC group outperformed the patient groups; 2. Robust relationship between the short and long forms for the UPSA; and 3. a pattern of longitudinal stability in the HC group and decline in the AD group. This set of results is in keeping with our predictions.