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LoBuono DL, Shea KS, Tovar A, Leedahl SN, Mahler L, Xu F, Lofgren IE. Diet Quality and Nutrition Concerns of People with Parkinson's Disease and Their Informal Caregivers: A Mixed Methods Study. J Nutr Gerontol Geriatr 2022; 41:1-21. [PMID: 35048783 DOI: 10.1080/21551197.2021.2024478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Limited research exists regarding the diet quality and nutritional concerns of people with Parkinson's disease (PwPD) and their informal caregivers. The study's purpose was to assess diet quality via the Healthy Eating Index-2015 (HEI-2015) and self-reported nutrition concerns via semi-structured, dyadic interviews of 20 PwPD (69.7 ± 9.2 yrs) and their caregivers (66.7 ± 13.0 yrs). HEI-2015 scores were 58.3 ± 12.4 and 58.1 ± 10.6 for PwPD and caregivers, respectively. Reported dietary concerns related to PD included: change in appetite or amount eaten, gastrointestinal issues, food-medication management, chewing/swallowing issues, and change in taste/smell. The poor diet quality and nutrition concerns identified suggest nutrition professionals and caregivers are critical on the healthcare team to promote optimal health among PwPD. Future research should address overall and specific aspects of diet quality, and nutritional concerns identified by dyads in this study, such as gastrointestinal issues and food-medication management.
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Affiliation(s)
- Dara L LoBuono
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Kyla S Shea
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Skye N Leedahl
- Department of Human Development and Family Science, University of Rhode Island, Kingston, RI, USA
| | - Leslie Mahler
- Department of Communicative Disorders, University of Rhode Island, Kingston, RI, USA
| | - Furong Xu
- School of Education, University of Rhode Island, Kingston, RI, USA
| | - Ingrid E Lofgren
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
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Lea R, Benge JF, Adler CH, Beach TG, Belden CM, Zhang N, Shill HA, Driver-Dunckley E, Mehta SH, Atri A. An initial exploration of the convergent and ecological validity of the UDS 3.0 neuropsychological battery in Parkinson's Disease. J Clin Exp Neuropsychol 2021; 43:918-925. [PMID: 35138228 PMCID: PMC8881345 DOI: 10.1080/13803395.2022.2034753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The Uniform Data Set 3.0 neuropsychological battery (UDS3NB) is well developed for research with Alzheimer's disease and related dementias, and may serve as a common set of measures of cognitive decline across neurodegenerative diseases. However, the battery has not been formally assessed in persons with Parkinson's disease (PD). The current research provides initial information on the convergent and ecological validity of the UDS3NB in individuals with PD. METHODS Participants included 75 individuals diagnosed with PD from the Arizona Study of Aging and Neurodegenerative Disorders. Clinical dementia ratings, administered independently from the cognitive measures, identified individuals as having normal cognition (n = 38), Mild Cognitive Impairment (MCI; n = 25) and dementia (n = 12). UDS3NB measures were compared between these groups, and correlations between UDS3NB measures, gold standard neuropsychological measures, and informant rated activities of daily living ability (ADL) were evaluated. RESULTS At the group-level, UDS3NB scores followed the expected pattern with higher scores in participants with PD but no cognitive diagnosis and lower in those with dementia; scores in the MCI group were between these extremes. Convergent validity was suggested by moderate correlations between UDS specific measures (i.e., Craft story) and measures such as the RAVLT. Ecological validity was suggested by statistically significant correlations between UDS3NB performance and caregiver ratings of ADLs, with speed and executive functioning measures (Trailmaking A; r = -.51, p < .01; Trailmaking B; r = -.51, p < .01) most strongly related to reported daily functioning. CONCLUSIONS Findings provide initial support for the convergent and ecological validity of the UDS3NB in individuals with PD. Implications and future directions for this battery are discussed.
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Affiliation(s)
- RoShunna Lea
- Department of Neurology, Baylor Scott and White Health, Temple, TX, USA
| | - Jared F. Benge
- Department of Neurology, University of Texas Dell Medical School, University of Texas, Austin, TX
| | - Charles H. Adler
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Thomas G. Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ, USA
| | - Christine M. Belden
- Cleo Roberts Center, Banner Sun Health Research Institute, Sun City, AZ, USA
| | - Nan Zhang
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | | | - Erika Driver-Dunckley
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Shyamal H. Mehta
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Alireza Atri
- Cleo Roberts Center, Banner Sun Health Research Institute, Sun City, AZ, USA,Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
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Wolff L, Benge JF, Ortiz-Hernandez S, Beevers S, Armitage A, Park J, Drane DL. Apathy and actions- another consideration when theorizing about embodied nature of language in Parkinson's disease. JOURNAL OF COMMUNICATION DISORDERS 2021; 93:106144. [PMID: 34365120 PMCID: PMC8936005 DOI: 10.1016/j.jcomdis.2021.106144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 07/09/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
Objectives Individuals with Parkinson's disease (PD) have difficulty processing actions or verbs relative to nouns. Verb difficulties are thought to represent the coupling of language and motor networks. However, those with PD also frequently experience apathy. The overlap between apathy and action language difficulties is to date unexplored. Furthermore, whether verb/action fluency difficulty represents verb degradation (semantic/conceptual) or a selective lexical retrieval difficulty has not been determined. Methods In the current study, 20 individuals with PD without dementia completed cued action (verb) and animal (noun) fluency tasks in addition to assessments of apathy, cognition, and motor functioning. Results Individuals who exhibited impairments on action and animal fluency improved around 50% with the provision of cueing. The degree to which action fluency improved with cueing was correlated with behavioral/initiation apathy (rs=.56) as well as motor dysfunction (rs=-.57), while no similar relationship was found between those factors and nouns. Conclusions These findings suggest that impaired retrieval of actions and nouns are present in PD, but may have different underlying neuropsychological underpinnings. This provides preliminary support for grounded cognition models, which suggest the brain organizes information around motor, perceptual, and other networks. MESH terms Parkinson Disease, Neurocognitive Disorders, Apathy, Language Disorders, Neuropsychological Tests, Cognition.
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Affiliation(s)
- Logan Wolff
- Department of Neurology and Plummer Movement Disorders Center, 2401 S. 31(st) Street, Temple, TX, United States 76508; Present Address: Capitol Hill Mental Health, Kaiser Permanente, 310 15(th) Ave E, Seattle WA 98112, United States
| | - Jared F Benge
- Department of Neurology and Plummer Movement Disorders Center, 2401 S. 31(st) Street, Temple, TX, United States 76508; Department of Neurology, University of Texas at Austin, 1601 Trinity St., Bldg. B, Stop Z0700, Austin, TX 78712, United States.
| | - Samia Ortiz-Hernandez
- Department of Neurology and Plummer Movement Disorders Center, 2401 S. 31(st) Street, Temple, TX, United States 76508; Washington DC VA Medical Center 50 Irving St NW, GC-211N, Washington, DC 20422, United States
| | - Samantha Beevers
- Baylor Scott and White Research Institute, 2401 S. 31(st) Street, Temple, TX 76508, United States
| | - Alexandra Armitage
- Department of Neurology and Plummer Movement Disorders Center, 2401 S. 31(st) Street, Temple, TX, United States 76508
| | - Jungjun Park
- Department of Communication Sciences and Disorders, Baylor University, One Bear Place #97332, Waco, TX 76798, United States
| | - Daniel L Drane
- Departments of Neurology and Pediatrics, Emory University School of Medicine, Woodruff Memorial Research Building, Suite 6111, 101 Woodruff Circle, Atlanta, GA 30322, United States; Department of Neurology, University of Washington School of Medicine, Seattle, WA 98105, United States
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Crowley SJ, Banan G, Amin M, Tanner JJ, Hizel L, Nguyen P, Brumback B, Rodriguez K, McFarland N, Bowers D, Ding M, Mareci TA, Price CC. Statistically Defined Parkinson's Disease Executive and Memory Cognitive Phenotypes: Demographic, Behavioral, and Structural Neuroimaging Comparisons. JOURNAL OF PARKINSONS DISEASE 2021; 11:283-297. [PMID: 33216042 DOI: 10.3233/jpd-202166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Some individuals with Parkinson's disease (PD) experience working memory and inhibitory difficulties, others learning and memory difficulties, while some only minimal to no cognitive deficits for many years. OBJECTIVE To statistically derive PD executive and memory phenotypes, and compare PD phenotypes on disease and demographic variables, vascular risk factors, and specific neuroimaging variables with known associations to executive and memory function relative to non-PD peers. METHODS Non-demented individuals with PD (n = 116) and non-PD peers (n = 62) were recruited to complete neuropsychology measures, blood draw, and structural magnetic resonance imaging. Tests representing the cognitive domains of interest (4 executive function, 3 memory) were included in a k-means cluster analysis comprised of the PD participants. Resulting clusters were compared demographic and disease-related variables, vascular risk markers, gray/white regions of interest, and white matter connectivity between known regions involved in executive and memory functions (dorsolateral prefrontal cortices to caudate nuclei; entorhinal cortices to hippocampi). RESULTS Clusters showed: 1) PD Executive, n = 25; 2) PD Memory, n = 35; 3) PD Cognitively Well; n = 56. Even after disease variable corrections, PD Executive had less subcortical gray matter, white matter, and fewer bilateral dorsolateral-prefrontal cortex to caudate nucleus connections; PD Memory showed bilaterally reduced entorhinal-hippocampal connections. PD Cognitively Well showed only reduced putamen volume and right entorhinal cortex to hippocampi connections relative to non-PD peers. Groups did not statistically differ on cortical integrity measures or cerebrovascular disease markers. CONCLUSION PD cognitive phenotypes showed different structural gray and white matter patterns. We discuss data relative to phenotype demographics, cognitive patterns, and structural brain profiles.
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Affiliation(s)
- Samuel J Crowley
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Guita Banan
- Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Manish Amin
- Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Jared J Tanner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Loren Hizel
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Peter Nguyen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Babette Brumback
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Katie Rodriguez
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Nikolaus McFarland
- Department of Neurology, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Dawn Bowers
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Mingzhou Ding
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Thomas A Mareci
- Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
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Benge JF, Kiselica AM. Rapid communication: Preliminary validation of a telephone adapted Montreal Cognitive Assessment for the identification of mild cognitive impairment in Parkinson's disease. Clin Neuropsychol 2020; 35:133-147. [PMID: 32779959 DOI: 10.1080/13854046.2020.1801848] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective: In the current pandemic, tele-screening of neuropsychological status has become a necessity. Instruments developed for telephone screening are not as well validated as traditional neuropsychological measures. Therefore, the current study presents preliminary validation of a telephone version of the Montreal Cognitive Assessment (T-MoCA) in individuals with Parkinson's disease (PD).Method: Twenty-one persons with PD completed the T-MoCA along with a traditional neuropsychological battery. Diagnostic accuracy for the presence of PD-related mild cognitive impairment (MCI) and correlations with traditional neuropsychological measures are reported.Results: Individuals with MCI (n = 9) scored lower than individuals without cognitive impairment (17.56 vs. 19.50; t = -2.28, p = .03, d = -1.00). Diagnostic accuracy for MCI ranged from 76% to 81%, with sensitivity ranging from 0.56 to 0.67 and specificity ranging from 0.92 to 1.00. Correlations of T-MoCA derived scores with traditional neuropsychological measures were quite modest, with the exception of the memory impairment scale.Conclusions: This rapid communication presents preliminary validation of the T-MoCA for use in individuals with PD. Caveats and implications for practical use in the current pandemic are discussed.
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Affiliation(s)
- Jared F Benge
- Department of Neurology, Baylor Scott and White Health, Temple, TX, USA.,Plummer Movement Disorder Center, BSWH Health, Temple, TX, USA.,Texas A&M College of Medicine, Temple, TX, USA
| | - Andrew M Kiselica
- Department of Neurology, Baylor Scott and White Health, Temple, TX, USA
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