Objective: The Erlangen Test of Activities of Daily Living (E-ADL) is a performance-based test to assess the activity of daily living (ADL) dysfunction associated with Alzheimer’s disease. Here, we evaluated the objectivity, reliability, and validity of the E-ADL for cognitive impairment and dementia in Parkinson’s disease (PD).

Background: Cognitive decline that lowers ADL abilities is the core feature of Parkinson’s disease dementia (PDD). Most assessments measure ADLs indirectly, as they are questionnaires, which are self-reported, relative-reported or caretaker/nurse-reported. Although these measures are quick and economical, they are limited in their objectivity. For an early and valid diagnosis of PDD, an unbiased, quick, and easy to administer ADL assessment is needed.

Methods: Data of 106 PD patients, assigned to the groups of no cognitive impairment (PD-NC, n=40), mild cognitive impairment (PD-MCI, n=45) and PDD (n=21) were analyzed. The E-ADL consists of five tasks relevant to daily living: (1) pouring a drink, (2) cutting a piece of bread, (3) opening a little cupboard, (4) washing hands, and (5) tying a bow. Further ADL (e.g. Multiple Object Test, Schwab & England Scale), motor (e.g. Hoehn & Yahr stage) and non-motor (e.g. Beck Depression Inventory, Neuropsychiatric Inventory) assessments were applied.

Results:  Good objectivity of the E-ADL could be determined by the means of high inter-rater reliability (rs = 0.85). Item discrimination, Cronbach’s alpha (0.31), and inter-item correlation indicated little redundancy amongst items. High values in item difficulty (> 90%) showed that the test was too easy for most patients. Construct validity revealed relation of the E-ADL and other ADL measures indicating that the E-ADL was a valid test to assess ADL performance. Additionally, correlations of the E-ADL performance with motor performance (p<0.001) and mood (p<0.001) were detected. An ordinal regression and Receiver Operating Characteristics (ROC) analysis revealed that the E-ADL was not able to discriminate between PD-NC and PD-MCI, but was sufficient for diagnosis of PDD (Sensitivity 66%; specificity 77%).

Conclusions: The E-ADL is an easily administered test with good objectivity and validity for diagnosis of PDD. However, its discriminant ability for the early stages of PDD is low.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/validation-of-the-performance-based-erlangen-test-of-activities-of-daily-living-in-pd/