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Abstract：
A key distinguishing factor between mild cognitive impairment (MCI) and dementia in Parkinson\'s disease (PD) lies in the notable decrease in functioning due to cognitive impairment. The Parkinson\'s Disease-Cognitive Functional Rating Scale (PD-CRFS) was developed to assess functional limitations caused by cognitive impairment, while reducing the influence of motor impairment. The aim of this multicenter study was to (i) validate the Italian version of the PD-CFRS in PD, (ii) determine optimal cut-off scores for detecting MCI and dementia in PD, (iii) compare its performances with the most established functional assessment tool (IADL). Six hundred and sixty nine PD participants were recruited from 4 Italian Movement Disorders centers (Venice, Milan, Gravedona, and Salerno). They underwent Level-II cognitive evaluation, which resulted in 282 PD-NC, 310 PD-MCI, and 77 PDD. The PD-CFRS\'s psychometric and clinimetric properties, applicability, and responsiveness were analyzed. The PD-CFRS showed high acceptability. Floor and ceiling effects were acceptable. It also displayed strong internal consistency (Cronbach\'s α = 0.738), and test-retest reliability (ICC = .854). The PD-CFRS demonstrated higher coefficient of variation to detect dysfunction in PD-MCI patients in comparison to the IADL scale (PD-CFRS 96% vs IADL 22.5%). Convergent validity with the IADL was r = - 0.638 and - 0.527 in males and females, respectively. PD-CFRS total score negatively correlated with global cognition (MoCA corrected score r = - 0.61; p < 0.001). A cut-off score > 6.5 identified PDD with a sensitivity of 90% and specificity of 88% (AUC = .959). A cut-off value of > 1 detected PD-MCI with a sensitivity of 68% and specificity of 69% (AUC = .695). The Italian version of the PD-CFRS demonstrated to be an easy, valid and reliable tool that properly captures functional impairment due to cognitive decline in PD. It also proved to be particularly effective in the advanced stages of PD, and would be a useful support for the diagnosis of PD-MCI and PDD.
摘要：
帕金森病(PD)中轻度认知障碍(MCI)和痴呆的一个关键区别因素在于认知障碍导致的功能显著下降。帕金森病-认知功能评定量表（PD-CRFS）用于评估由认知障碍引起的功能限制，同时减少运动障碍的影响。这项多中心研究的目的是（i）验证PD-CFRS的意大利语版本，（ii）确定用于检测PD中MCI和痴呆的最佳截止分数，(iii)将其性能与最成熟的功能评估工具(IADL)进行比较。从4个意大利运动障碍中心招募了669名PD参与者(威尼斯，米兰,Gravedona,和萨勒诺）。他们接受了二级认知评估，导致282个PD-NC，310PD-MCI和77PDD。PD-CFRS的心理测量学和临床测量学特性，适用性,和反应性进行了分析。PD-CFRS显示出较高的可接受性。地板和天花板效果是可以接受的。它还显示出很强的内部一致性(克朗巴赫的α=0.738)，和重测可靠性（ICC=.854）。与IADL量表相比，PD-CFRS显示出更高的变异系数来检测PD-MCI患者的功能障碍（PD-CFRS96％vsIADL22.5％）。男性和女性与IADL的收敛效度分别为r=-0.638和-0.527，分别。PD-CFRS总分与整体认知呈负相关（MoCA校正评分r=-0.61；p<0.001）。>6.5的截止评分确定PDD具有90%的灵敏度和88%的特异性(AUC=.959)。>1的截断值以68%的灵敏度和69%的特异性检测到PD-MCI(AUC=.695)。意大利版的PD-CFRS被证明是一个简单的，有效且可靠的工具，可以正确捕获由于PD认知下降而导致的功能障碍。在PD的晚期阶段也被证明特别有效，并将为PD-MCI和PDD的诊断提供有用的支持。
