Development and Cross-Validation of the UPSA Short Form for the Performance-Based Functional Assessment of Patients With Mild Cognitive Impairment and Alzheimer Disease

作者：Gomar Jesus J; Harvey Philip D; Bobes Bascaran Maria T; Davies Peter; Goldberg Terry E^*

来源：American Journal of Geriatric Psychiatry, 2011, 19(11): 915-922.

DOI：10.1097/JGP.0b013e3182011846

• Alzheimer disease
• cognitive impairment
• functional assessment
• instrumental activities
• mild cognitive impairment
• UPSA

Background: Functional capacity includes basic and complex behaviors necessary to independently live in the community. It has been found that patients with cognitive impairment have daily living functional skills altered at very early stages of illness. Objectives: 1) To develop and validate a brief scale derived from the University of California, San Diego, performance-based skills assessment (UPSA); 2) to cross-validate this new UPSA short form with an independent healthy elderly sample. Method: Fifty-one healthy elderly subjects, 26 mild cognitive impairment (MCI) subjects defined per Petersen's criteria, and 22 probable Alzheimer Disease (AD) subjects according to National Institute of Neurological and Communicative Disorders and Stroke-AD and Related Disorders Association criteria were included. For cross-validation purpose, a comparison group of 108 older healthy subjects with Mini-Mental scores of 25 or greater was also recruited. A modified four-functional domain version of the UPSA was administered. Results: Communication and comprehension/planning domains accounted for almost 90% of the variance (R-2 = 0.89) and in all models entered first and second, respectively. An UPSA short form using these two domains was significantly correlated with the full UPSA scale in all the groups examined: 0.86 for healthy controls; 0.87 for MCI; and 0.88 for AD. Acceptable sensitivity and specificity values for the UPSA short form were found in receiver operating characteristic (ROC) analysis. A correlation of 0.80 was found between the short and the full UPSA scales in the cross-validation sample. Conclusions: The UPSA short form is a rapid, reliable, and efficient measure of functional capacity that is able to detect performance impairment in an ecologically valid setting in much less time compared with the extended form of the scale. Furthermore, it demonstrated adequate discriminative properties among healthy subjects, MCI patients, and AD patients. (Am J Geriatr Psychiatry 2011; 19:915-922)

• 出版日期2011-11