UPSA

: avaliação do desempenho funcional nos diferentes estádios de declínio cognitivo

Abstract

Introduction: Dementia is an acquired clinical syndrome, characterized by aprogressive decline of several cognitive areas. Deficits are persistent and severe enoughto interfere with social relations and with the ability to perform independently theactivities of daily living. Several studies showed that impairment in instrumentalactivities of daily living (IADL) predict significantly dementia development. In order toevaluate IADL, performance-based instruments showed to be more sensitivedifferentiating cognitive healthy subjects from cognitive impairment subjects. The aimof this dissertation is to translate and adapt the second version of UCSD-PerformanceBased Skills Assessment (UPSA-2), a performance-based instrument developed forassessing IADL and to verify if exists differences in functional ability in the differentstages of cognitive decline.Methodology: The sample was composed by 81 subjects, 34 subjects from thecognitively healthy group, 23 from the mild cognitive impairment group and 24 fromthe severe cognitive impairment group. The subjects were distributed between thegroups according to the established inclusion criteria.Results: UPSA-2 final results were significantly lower in severe cognitive impairmentsubjects, than mild cognitive impairment subjects, which in turn were lower thancognitively healthy subjects. UPSA-2 final result is strongly correlated with theAlzheimer’s Disease Cooperative Study scale, Cognitive sub-scale (ADAS-Cog) (r=-0.84/p<0.001) and the Instrumental Activities of Daily Living scale (IADL) (rs=-0.78/p<0.001). We also have verified that subjects without functional impairments in IADL scale, showed impairments in the UPSA-2 several domains. Conclusion: UPSA-2 is a functional assessment tool that discriminates the functional performance of cognitively healthy subjects, from the performance of mild and severe cognitive impairment subjects. This study showed that UPSA-2 has more sensibility inIADL assessment, than a self-report measure. Also, highlights the strong association between cognitive and functional performance.

Date of Award	18 Jun 2020
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Filipa Ribeiro (Supervisor)