{"title":"Temporal Sequence of Cognitive Function and ADLs and Mediation Effect of Apathy in Parkinson's Disease: Cross-Lagged Analyses.","authors":"Xiaofang Cui, Xiao Lu, Sidan Du, Hongmei Yu","doi":"10.1080/07317115.2024.2426182","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To explore the temporal sequence between cognitive function and activities of daily living (ADLs) in patients with Parkinson's disease (PD) and investigate whether apathy mediates these effects.</p><p><strong>Methods: </strong>We recruited 486 patients from the Parkinson's Progression Marker Initiative. We constructed a cross-lagged panel model to explore the temporal sequence between cognitive function and ADLs and analyzed the longitudinal mediating effect of apathy on the relationship between cognitive function and ADLs.</p><p><strong>Results: </strong>The slopes of ADLs and cognitive function were significant (<i>p</i> < .001), and lower levels of cognitive function indicated lower ADLs, suggesting that a decreased cognitive performance preceded ADLs decline. Cognitive function influenced apathy (negatively) (<i>p</i> < .001) and ADLs (<i>p</i> < .001). A significant indirect effect of cognitive function on ADLs through apathy was revealed by bias-corrected bootstrapping (β = 0.181, <i>p</i> < .001).</p><p><strong>Conclusions: </strong>The rate of change in cognitive function was significantly correlated with that of ADLs, and a decreased cognitive performance preceded ADLs decline. Cognition was indirectly related to ADLs through apathy.</p><p><strong>Clinical implications: </strong>The rate of change in cognitive function in patients with PD was correlated with that of ADLs, and a decreased cognitive performance preceded ADLs decline. Reducing apathy represents a promising approach to reducing the impact of cognitive decline on ADLs.</p>","PeriodicalId":10376,"journal":{"name":"Clinical Gerontologist","volume":" ","pages":"1-13"},"PeriodicalIF":2.6000,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Gerontologist","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/07317115.2024.2426182","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To explore the temporal sequence between cognitive function and activities of daily living (ADLs) in patients with Parkinson's disease (PD) and investigate whether apathy mediates these effects.
Methods: We recruited 486 patients from the Parkinson's Progression Marker Initiative. We constructed a cross-lagged panel model to explore the temporal sequence between cognitive function and ADLs and analyzed the longitudinal mediating effect of apathy on the relationship between cognitive function and ADLs.
Results: The slopes of ADLs and cognitive function were significant (p < .001), and lower levels of cognitive function indicated lower ADLs, suggesting that a decreased cognitive performance preceded ADLs decline. Cognitive function influenced apathy (negatively) (p < .001) and ADLs (p < .001). A significant indirect effect of cognitive function on ADLs through apathy was revealed by bias-corrected bootstrapping (β = 0.181, p < .001).
Conclusions: The rate of change in cognitive function was significantly correlated with that of ADLs, and a decreased cognitive performance preceded ADLs decline. Cognition was indirectly related to ADLs through apathy.
Clinical implications: The rate of change in cognitive function in patients with PD was correlated with that of ADLs, and a decreased cognitive performance preceded ADLs decline. Reducing apathy represents a promising approach to reducing the impact of cognitive decline on ADLs.
目的探讨帕金森病（PD）患者认知功能与日常生活活动（ADLs）之间的时间顺序，并研究冷漠是否会介导这些影响：我们从帕金森病进展标志倡议中招募了 486 名患者。我们构建了一个交叉滞后的面板模型来探讨认知功能和日常活动能力之间的时间序列，并分析了冷漠对认知功能和日常活动能力之间关系的纵向中介效应：ADLs 和认知功能的斜率显著（p p p p 结论：认知功能的变化率与 ADLs 的斜率显著相关：认知功能的变化率与ADLs的变化率显著相关，认知能力的下降先于ADLs的下降。认知能力通过冷漠与日常活动能力间接相关：临床意义：帕金森病患者认知功能的变化率与日常活动能力的变化率相关，认知能力下降先于日常活动能力下降。减少冷漠是减少认知功能下降对日常活动能力影响的一种可行方法。
期刊介绍：
Clinical Gerontologist presents original research, reviews, and clinical comments relevant to the needs of behavioral health professionals and all practitioners who work with older adults. Published in cooperation with Psychologists in Long Term Care, the journal is designed for psychologists, physicians, nurses, social workers, counselors (family, pastoral, and vocational), and other health professionals who address behavioral health concerns found in later life, including:
-adjustments to changing roles-
issues related to diversity and aging-
family caregiving-
spirituality-
cognitive and psychosocial assessment-
depression, anxiety, and PTSD-
Alzheimer’s disease and other neurocognitive disorders-
long term care-
behavioral medicine in aging-
rehabilitation and education for older adults.
Each issue provides insightful articles on current topics. Submissions are peer reviewed by content experts and selected for both scholarship and relevance to the practitioner to ensure that the articles are among the best in the field. Authors report original research and conceptual reviews. A unique column in Clinical Gerontologist is “Clinical Comments." This section features brief observations and specific suggestions from practitioners which avoid elaborate research designs or long reference lists. This section is a unique opportunity for you to learn about the valuable clinical work of your peers in a short, concise format.
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