Psychometric properties of the Autonomic Symptoms Checklist in the Lewy body disease module of the uniform dataset

Abigail B Waters; John B Williamson; Andrew M Kiselica

doi:10.1002/gps.5838

Psychometric properties of the Autonomic Symptoms Checklist in the Lewy body disease module of the uniform dataset

Int J Geriatr Psychiatry. 2022 Dec;37(12). doi: 10.1002/gps.5838.

Authors

Abigail B Waters^{1

2

3}, John B Williamson^{3

4}, Andrew M Kiselica¹

Affiliations

¹ Department of Health Psychology, University of Missouri, Columbia, Missouri, USA.
² Department of Psychology, Suffolk University, Boston, Massachusetts, USA.
³ North Florida/South Georgia Veterans Affairs Medical Center, Gainesville, Florida, USA.
⁴ Center for Obsessive Compulsive and Anxiety Related Disorder, Department of Psychiatry, University of Florida, Gainesville, Florida, USA.

PMID: 36380553
DOI: 10.1002/gps.5838

Abstract

Introduction: Autonomic dysfunction is an important feature of Lewy Body Dementia (DLB), but measurement of autonomic symptoms has been limited in both previous research and clinical practice. Accurate measurement of autonomic dysfunction has the potential to improve our understanding of the course and progression of DLB, given that autonomic symptoms typically precede cognitive impairment and are associated with functional impairment. The primary aim of this study was to examine the psychometric properties of the two versions (3.0 and 3.1) of the NACC LBD-module Autonomic Symptom Checklist (ASC).

Methods: Psychometric analyses of the ASC (internal consistency, reliability, factor structure, and validity) were conducted on data acquired from 245 individuals with DLB from the NACC database. ASC V3.0 was contrasted on these attributes to V3.1.

Results: Results suggested an underlying factor structure for the ASC, and confirmatory factor analysis (CFA) revealed 3 factors, which generally aligned with discrete autonomic systems. The ASC V3.0 and CFA-identified scales were comparable in terms of reliability, which were both improved relative to the ASC V3.1. In terms of ecological validity, CFA-identified items related to gastrointestinal/thermoregulation symptoms were significantly more associated with functional outcomes compared to the unitary ASC.

Conclusion: Findings underscore the importance of differentiation within the autonomic system. Future research into autonomic symptom classes and lab-based pathophysiological measurement of autonomic dysfunction in DLB has the potential to support early identification and inform treatment planning.

Keywords: Lewy body; autonomic symptoms; psychometrics; reliability; validity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Checklist
Cognitive Dysfunction* / complications
Humans
Lewy Body Disease*
Psychometrics
Reproducibility of Results