Extended "Timed Up and Go" assessment as a clinical indicator of cognitive state in Parkinson's disease

Tess Evans; Alexa Jefferson; Michelle Byrnes; Sue Walters; Soumya Ghosh; Frank L Mastaglia; Brian Power; Ryan S Anderton

doi:10.1016/j.jns.2017.01.050

Extended "Timed Up and Go" assessment as a clinical indicator of cognitive state in Parkinson's disease

J Neurol Sci. 2017 Apr 15:375:86-91. doi: 10.1016/j.jns.2017.01.050. Epub 2017 Jan 17.

Authors

Tess Evans¹, Alexa Jefferson², Michelle Byrnes³, Sue Walters³, Soumya Ghosh³, Frank L Mastaglia⁴, Brian Power¹, Ryan S Anderton⁵

Affiliations

¹ School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia.
² Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia.
³ Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia; Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia.
⁴ Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia; Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia.
⁵ Western Australian Neuroscience Research Institute, A Block, QEII Medical Centre, Nedlands, WA, Australia; Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Nedlands, WA, Australia; School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia. Electronic address: ryan.anderton@nd.edu.au.

PMID: 28320196
DOI: 10.1016/j.jns.2017.01.050

Abstract

Objective: To evaluate a modified extended Timed Up and Go (extended-TUG) assessment against a panel of validated clinical assessments, as an indicator of Parkinson's disease (PD) severity and cognitive impairment.

Methods: Eighty-seven participants with idiopathic PD were sequentially recruited from a Movement Disorders Clinic. An extended-TUG assessment was employed which required participants to stand from a seated position, walk in a straight line for 7m, turn 180° and then return to the start, in a seated position. The extended-TUG assessment duration was correlated to a panel of clinical assessments, including the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Quality of Life (PDQ-39), Scales for Outcomes in Parkinson's Disease (SCOPA-Cog), revised Addenbrooke's Cognitive Index (ACE-R) and Barratt's Impulsivity Scale 11 (BIS-11).

Results: Extended-TUG time was significantly correlated to MDS-UPDRS III score and to SCOPA-Cog, ACE-R (p<0.001) and PDQ-39 scores (p<0.01). Generalized linear models determined the extended-TUG to be a sole variable in predicting ACE-R or SCOPA-Cog scores. Patients in the fastest extended-TUG tertile were predicted to perform 8.3 and 13.4 points better in the SCOPA-Cog and ACE-R assessments, respectively, than the slowest group. Patients who exceeded the dementia cut-off scores with these instruments exhibited significantly longer extended-TUG times.

Conclusions: Extended-TUG performance appears to be a useful indicator of cognition as well as motor function and quality of life in PD, and warrants further evaluation as a first line assessment tool to monitor disease severity and response to treatment. Poor extended-TUG performance may identify patients without overt cognitive impairment form whom cognitive assessment is needed.

Keywords: Cognitive state; Parkinson's disease; SCOPA; Timed Up and Go.

MeSH terms

Adult
Aged
Aged, 80 and over
Analysis of Variance
Cognition Disorders / diagnosis*
Cognition Disorders / etiology*
Cohort Studies
Female
Humans
Male
Middle Aged
Movement / physiology*
Neuropsychological Tests*
Parkinson Disease / complications*
Time Factors