Background

Verbal fluency (VF) tasks are known as suitable for detecting cognitive impairment (CI) in Parkinson’s disease (PD). This study thus aimed to evaluate the psychometrics and diagnostics of the Alternate Verbal Fluency Battery (AVFB) by Costa et al. (2014) in an Italian cohort of non-demented PD patients, as well as to derive disease-specific cut-offs for it.

Methods

N = 192 non-demented PD patients were screened with the Montreal Cognitive Assessment (MoCA) and underwent the AVFB—which includes phonemic, semantic and alternate VF tests (PVF; SVF; AVF), as well as a Composite Shifting Index (CSI) reflecting the “cost” of shifting from a single- to a double-cued VF task. Construct validity and diagnostics were assessed for each AVFB measure against the MoCA. Internal reliability and factorial validity were also tested.

Results

The MoCA proved to be strongly associated with PVF, SVF and AVF scores, whilst moderately with the CSI. The AVFB was internally consistent and underpinned by a single component; however, an improvement in both internal reliability and fit to its factorial structure was observed when dropping the CSI. Demographically adjusted scores on PVF, SVF and AVF tests were diagnostically sound in detecting MoCA-defined cognitive impairment, whilst this was not true for the CSI. Disease-specific cut-offs for PVF, SVF and AVF tests were derived.

Discussion

In conclusion, PVF, SVF and AVF tests are reliable, valid and diagnostically sound instruments to detect cognitive impairment in non-demented PD patients and are therefore recommended for use in clinical practice and research.

中文翻译：

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非痴呆帕金森病患者意大利语版备用语言流畅性电池 (AVFB) 的心理测量和诊断

背景

语言流利度 (VF) 任务被认为适合检测帕金森病 (PD) 中的认知障碍 (CI)。因此，本研究旨在评估 Costa 等人的备用言语流利电池 (AVFB) 的心理测量和诊断。(2014) 在意大利非痴呆 PD 患者队列中进行了研究，并得出了疾病特异性的临界值。

方法

N  = 192 名非痴呆 PD 患者接受了蒙特利尔认知评估 (MoCA) 筛查，并接受了 AVFB，其中包括音位、语义和替代 VF 测试（PVF；SVF；AVF）以及综合转移指数 (CSI)反映了从单提示 VF 任务转变为双提示 VF 任务的“成本”。针对 MoCA 评估每个 AVFB 测量的构建有效性和诊断。还测试了内部信度和因子效度。

结果

事实证明，MoCA 与 PVF、SVF 和 AVF 分数密切相关，而与 CSI 则有一定的相关性。AVFB 内部一致并由单个组件支撑；然而，当放弃 CSI 时，观察到内部可靠性和与其阶乘结构的拟合度都有所提高。PVF、SVF 和 AVF 测试的人口统计调整分数在检测 MoCA 定义的认知障碍方面具有良好的诊断性，而 CSI 则不然。得出了 PVF、SVF 和 AVF 测试的疾病特异性截止值。

讨论

总之，PVF、SVF 和 AVF 测试是检测非痴呆 PD 患者认知障碍的可靠、有效且诊断合理的工具，因此建议在临床实践和研究中使用。