Assessment of adaptive functioning in Huntington's disease

Area of Science:

• Neuroscience
• Clinical Assessment
• Patient-Reported Outcomes

Background:

• Huntington's disease (HD) significantly impacts patients' daily lives and adaptive functioning.
• Accurate assessment tools are crucial for monitoring disease progression and treatment efficacy in HD.
• The Huntington's Disease Activities of Daily Living (HD-ADL) scale is an informant-completed instrument designed for this purpose.

Purpose of the Study:

• To evaluate the reliability and clinical correlates of the HD-ADL scale in Huntington's disease patients.
• To determine the psychometric properties and predictive validity of the HD-ADL scale.
• To establish the HD-ADL scale as a dependable tool for assessing adaptive functioning in HD.

Main Methods:

• The HD-ADL scale was administered to 93 HD patients alongside the Mini-Mental State Exam (MMSE) and Quantified Neurological Exam (QNE).
• Internal consistency was assessed using coefficient alpha, and factor analysis was performed on the HD-ADL data.
• Correlations were examined between HD-ADL scores and other clinical measures, including the Total Functional Capacity (TFC) index.

Main Results:

• The HD-ADL scale demonstrated high internal consistency (coefficient alpha = 0.91).
• Factor analysis identified four key factors: General Functioning, Domestic Activities, Home Upkeep, and Family Relationships, explaining 72% of the variance.
• MMSE score, motor impairment, and disease duration were significant predictors of HD-ADL scores. A strong negative correlation (r = -0.89) was found with the TFC index.

Conclusions:

• The HD-ADL scale is a reliable and valid instrument for assessing adaptive functioning in Huntington's disease patients.
• Its strong correlation with established clinical measures supports its utility in clinical practice and research.
• The scale effectively captures the functional impact of HD across various domains of daily living.