Clinical Manifestations

Background: The study aimed to evaluate the validity of the Korean version of the University of California San Diego Performance-based Skills Assessment, Validation of Intermediate Measures (K-UPSA-2-VIM) in patients with dementia (D), Mild cognitive impairment (MCI), cognitive normal control group (CN), and explore the usefulness of the instrument as a measure of ADL in older adults with cognitive disorder.

Method: Study participants were 25 patients with D, 43 patients with MCI, 111 controls with CN group, respectively. For cognitive assessment, Mini Mental State Examination (K-MMSE-2), Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery (CERAD-K-NP), Clinical Dementia Rating (CDR) were used. For functional assessment, Barthel-Activities of Daily Living (B-ADL), Instrumental Activities of Daily Living (K-IADL), Dementia Screening questionnaire (K-DSQ), K-UPSA-2-VIM were used. Multivariate Analysis of Covariance (MANCOVA) was conducted to assess whether statistically significant differences existed in the scores of K-UPSA-2-VIM and functional assessment measures among the different cognitive subgroups. Receiver Operating Characteristic (ROC) curve analyses were conducted to determine the optimal cut-off scores for K-UPSA-2-VIM that exhibit maximum sensitivity and specificity in discriminating between CN and MCI groups, MCI and D groups, in respectively.

Result: Statistically significant differences were observed in all subdomains and total score of the K-UPSA-2-VIM among three cognitive groups. All subdomains and the total score of K-UPSA-2-VIM demonstrated a significant correlation with all subdomains of CERAD-K-NP. K-UPSA-2-VIM demonstrated 75.7% of sensitivity and 65.1% of specificity, with an area under the curve (AUC) of 0.731 (95% CI:0.641-0.821, p < 0.001) in discriminating between CN and MCI groups. In discriminating between MCI and D groups, 76.7% of sensitivity and 64.0% of specificity, with an AUC of 0.706 (95% CI:0.580-0.833, p = 0.005) were demonstrated.

Conclusion: Our study results suggest that the K-UPSA-2-VIM has diagnostic validity in Korean patients with dementia and mild cognitive impairment. The K-UPSA-2-VIM is useful for assessing patients, including elderly individuals living alone without caregivers.