Usefulness of the University of California San Diego Performance-Based Skills Assessment for the evaluation of cognitive function and activities of daily living function in patients with cognitive impairment

AbstractEveryday functioning (EF) impairment is frequent in people living with HIV (PLWH). Our aim was to better explore EF and its association with PLWH cognition, by administering both the IADL scale, the most common functional scale, and a new and ecologic multi-domain (communication and financial skills) tool to measure EF as the University of California San Diego (UCSD) Performance-Based Skills Assessment-Brief Version (UPSA-B). Eighty-five PLWH on cART with very good immunological condition and 23 age- and education-matched healthy controls (HC) were enrolled. PLWH underwent a standardized neuropsychological battery plus IADL, and cognitive impairment was defined according to Frascati criteria. Both groups underwent the UPSA-B. Only 6 subjects (7%) were affected by cognitive impairment (asymptomatic profile). While IADL score was at ceiling for all patients, the UPSA-B total score was significantly worse in PLWH when compared with HC [mean 82.1 (SD 9.3) vs 89.2 (SD 6.2); p < 0.001]. At communication subtest, PLWH group and HC were significantly different (p = 0.002), while no difference emerged at financial skills (p = 0.096). Higher score at UPSA-B was independently associated with better global cognitive performance (composite Z-score) (β 7.79; p < 0.001). Also considering each single cognitive domain, UPSA-B performance (both total and at subtests) confirmed the association with neurocognitive performance. In conclusion, UPSA-B seems to better discriminate EF impairment than IADL in PLWH, and it was associated with cognitive functions, also in the absence of symptomatic cognitive impairment. Thus, it appears a promising tool in the context of HIV infection to avoid misdiagnosis and to better detect also mild EF.

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PS83. Impact of Vortioxetine on Functional Capacity in MDD Patients with Subjective Cognitive Dysfunction: A Post-hoc Analysis of the University of California San Diego Performance-Based Skills Assessment

The International Journal of Neuropsychopharmacology ◽

10.1093/ijnp/pyw043.083 ◽

2016 ◽

Vol 19 (Suppl_1) ◽

pp. 28-28

Keyword(s):

Cognitive Dysfunction ◽

Functional Capacity ◽

San Diego ◽

University Of California ◽

Skills Assessment ◽

Post Hoc Analysis ◽

The University ◽

Post Hoc

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Validation of the University of California San Diego Performance-based Skills Assessment (UPSA) in major depressive disorder: Replication and extension of initial findings

Journal of Affective Disorders ◽

10.1016/j.jad.2018.11.034 ◽

2019 ◽

Vol 245 ◽

pp. 508-516 ◽

Cited By ~ 3

Author(s):

Michael Cronquist Christensen ◽

Lasse Breuning Sluth ◽

Roger S. McIntyre

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

San Diego ◽

University Of California ◽

Skills Assessment ◽

Major Depressive ◽

The University

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Age, Period, and Cohort Effects on Activities of Daily Living, Physical Performance, and Cognitive Functioning Impairment Among the Oldest-Old in China

The Journals of Gerontology Series A ◽

10.1093/gerona/glz196 ◽

2019 ◽

Vol 75 (6) ◽

pp. 1214-1221 ◽

Cited By ~ 2

Author(s):

Pei-Dong Zhang ◽

Yue-Bin Lv ◽

Zhi-Hao Li ◽

Zhao-Xue Yin ◽

Fu-Rong Li ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Activities Of Daily Living ◽

Physical Performance ◽

Functional Impairment ◽

Daily Living ◽

Oldest Old ◽

Cohort Effects ◽

Birth Cohorts ◽

Function Impairment

Abstract Background The aim of this study was to examine the trends in impairment regarding activities of daily living (ADL), physical performance, and cognitive function among the oldest-old (those aged 80 and older) in China between 1998 and 2014. Methods We used data on 34,297 oldest-old individuals from the seven waves of the Chinese Longitudinal Healthy Longevity Study. We estimated age, period, and cohort effects on the prevalence of self-reported ADL impairment, tested physical performance and cognitive function impairment using the age–period–cohort model. Results Regarding age, the prevalence of ADL, physical performance, and cognitive function impairment were highest in the centenarians, but they did not increase with age in this population. Among the literate subgroup, the prevalence of cognitive impairment increased more rapidly with age than that in the illiterate subgroup. Regarding period, the prevalence of self-reported and tested physical impairment slowly increased between 1998 and 2014, but cognitive impairment remained stable. Regarding cohort, ADL impairment continuously decreased. However, physical and cognitive impairment remained stable after a brief decline in the early birth cohorts. Conclusions The results suggest that the age effect is still the most obvious effect regarding several types of functional impairment. The likelihood of a younger person experiencing functional impairment may not change significantly, but ADL is likely to be amenable to improvement resulting from improved medical and social care. Therefore, increased care for the oldest-old may considerably improve their quality of life, particularly regarding their basic ADL.

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Two-year course of cognitive function and instrumental activities of daily living in older adults with bipolar disorder: evidence for neuroprogression?

Psychological Medicine ◽

10.1017/s0033291712001614 ◽

2012 ◽

Vol 43 (4) ◽

pp. 801-811 ◽

Cited By ~ 47

Author(s):

A. G. Gildengers ◽

D. Chisholm ◽

M. A. Butters ◽

S. J. Anderson ◽

A. Begley ◽

...

Keyword(s):

Older Adults ◽

Bipolar Disorder ◽

Cognitive Impairment ◽

Cognitive Function ◽

Activities Of Daily Living ◽

Cognitive Aging ◽

Repeated Measures ◽

Daily Living ◽

Time Points ◽

Instrumental Activities

BackgroundWhile bipolar disorder (BD) is a leading cause of disability, and an important contributor to disability in BD is cognitive impairment, there is little systematic research on the longitudinal course of cognitive function and instrumental activities of daily living (IADLs) in late-life. In this report, we characterize the 2-year course of cognitive function and IADLs in older adults with BD.MethodWe recruited non-demented individuals 50 years and older with BD I or BD II (n = 47) from out-patient clinics or treatment studies at the University of Pittsburgh. Comparator subjects (‘controls’) were 22 individuals of comparable age and education with no psychiatric or neurologic history, but similar levels of cardiovascular disease. We assessed cognitive function and IADLs at baseline, 1- and 2-year time-points. The neuropsychological evaluation comprised 21 well-established and validated tests assessing multiple cognitive domains. We assessed IADLs using a criterion-referenced, performance-based instrument. We employed repeated-measures mixed-effects linear models to examine trajectory of cognitive function. We employed non-parametric tests for analysis of IADLs.ResultsThe BD group displayed worse cognitive function in all domains and worse IADL performance than the comparator group at baseline and over follow-up. Global cognitive function and IADLs were correlated at all time-points. The BD group did not exhibit accelerated cognitive decline over 2 years.ConclusionsOver 2 years, cognitive impairment and associated functional disability of older adults with BD appear to be due to long-standing neuroprogressive processes compounded by normal cognitive aging rather than accelerated cognitive loss in old age.

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