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Development and validation of an alternative version of the Parkinson's Disease-Cognitive Rating Scale (PD-CRS)
Ramón Fernández-Bobadilla1, Saül Martínez-Horta2, Juan Marín-Lahoz3
1Movement Disorders Unit, Neurology Department, Hospital Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Centro Neurológico de Navarra, Imarcoain (Navarra), Spain; Universitat Autònoma de Barcelona (UAB), Spain.
Introduction:
The Parkinson's Disease-Cognitive Rating Scale (PD-CRS) is a valid and reliable instrument to screen for and diagnose mild cognitive impairment in PD (PD-MCI) and to monitor potential outcomes in clinical trials. Although this scale shows adequate sensitivity to change in non-demented PD patients, an alternative form (AF) with proven reliability could minimize practice effects associated with repeated testing.
Methods:
We selected PD-CRS/AF items following the criteria proposed in the original PD-CRS. We assessed a prospective sample of 75 non-demented PD patients (normal cognition, n = 50; PD-MCI, n = 25) using both tools, administered on two consecutive days, in a randomized order.
Results:
The PD-CRS/AF showed a high internal consistency (Cronbach's α = 0.80). Differences between total mean scores were not significant. Floor/ceiling effects were acceptable. The discriminative power for MCI was high for both tools (area under the curve 0.91; 95% CI, 0.84-0.98 for PD-CRS; 0.88, 95% CI, 0.80-0.96 for PD-CRS/AF). Receiver operating curve analysis showed the optimal cut-off point of the two versions to discriminate PD-MCI from PD-normal cognition was ≤81 (PD-CRS = sensitivity 94%, specificity 73%; PD-CRS/AF = sensitivity 92%, specificity 73%).
Conclusions:
Our results suggest that the PD-CRS/AF is a valid and reliable instrument to complement the original PD-CRS as an analogous tool for serial cognitive testing for PD patients in clinical practice and cognitive trials.
