title: Everyday cognition in prodromal Huntington disease.
abstract: OBJECTIVE
  Assessment of daily functions affected by cognitive loss in prodromal Huntington's disease (HD) is necessary in practice and clinical trials. We evaluated baseline and longitudinal sensitivity of the Everyday Cognition (ECog) scales in prodromal HD and compared self- and companion-ratings.
  
  
  METHODS
  Everyday cognition was self-assessed by 850 participants with prodromal HD and 768 companions. We examined internal structure using confirmatory factor analysis (CFA) on baseline data. For longitudinal analysis, we stratified participants into Low, Medium, and High disease progression groups. We examined ECog scores for group differences and participant-and-companion differences using linear mixed effects regression (LMER). Comparison with the Total Functional Capacity (TFC) scale was made.
  
  
  RESULTS
  CFA revealed good fit of a 5-factor model having a global factor (total score), and subfactors (subscales) of memory, language, visuospatial perception, and executive function. At study entry, participants and companions in the Medium and High groups reported significantly worsened everyday cognition as well as significant functional decline over time. Losses became more pronounced and participant and companion ratings diverged as individuals progressed. TFC showed significant functional loss over time in the High group but not in the Medium group.
  
  
  CONCLUSIONS
  Disease progression is associated with reduced self- and companion-reported everyday cognition in prodromal HD participants who are less than 13 years to estimated motor onset. Our findings suggest companion ratings are more sensitive than participants' for detecting longitudinal change in daily cognitive function. ECog appears more sensitive to specific functional changes in the prodrome of HD than the TFC.
authors.affiliation: College of Nursing, University of Iowa.
authors.forename: Janet K
authors.initials: JK
authors.lastname: Williams
authors.affiliation: Department of Psychiatry, Carver College of Medicine, University of Iowa.
authors.forename: Ji-In
authors.initials: JI
authors.lastname: Kim
authors.affiliation: College of Nursing, University of Iowa.
authors.forename: Nancy
authors.initials: N
authors.lastname: Downing
authors.affiliation: Department of Neurology, University of California, Davis.
authors.forename: Sarah
authors.initials: S
authors.lastname: Farias
authors.affiliation: Department of Radiology, University of California, San Diego.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Harrington
authors.affiliation: Department of Psychiatry, Carver College of Medicine.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Long
authors.affiliation: Department of Psychiatry, Carver College of Medicine.
authors.forename: James A
authors.initials: JA
authors.lastname: Mills
authors.affiliation: Department of Psychiatry, Carver College of Medicine.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Paulsen
mesh_terms: D000328:Adult; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D018450:Disease Progression; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000150:complications / Q000523:psychology*; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D062706:Prodromal Symptoms