INS NYC 2024 Program

Poster	Poster Session 02 Program Schedule 02/15/2024 08:00 am - 09:15 am Room: Majestic Complex (Posters 61-120) Poster Session 02: Aging \| MCI \| Neurodegenerative Disease - PART 1 Final Abstract #73 Cognitive and Military Predictors of Health-Related Quality of Life in Veterans with PD Deyran Paredes, Research Service, VA San Diego Healthcare System, La Jolla, United States Jennifer Adler, Research Service, VA San Diego Healthcare System, La Jolla, United States Ashley Carrillo, Research Service, VA San Diego Healthcare System, La Jolla, United States Lysette Desilva, Research Service, VA San Diego Healthcare System, La Jolla, United States Ece Bayram, Department of Neurosciences, Movement Disorder Center, University of California, San Diego, San Diego, United States Kristy Hwang, Department of Neurosciences, Movement Disorder Center, University of California, San Diego, San Diego, United States Dawn Schiehser, Department of Psychiatry, University of California, San Diego, San Diego, United States Category: Movement and Movement Disorders Keyword 1: Parkinson's disease Keyword 2: quality of life Objective: Health-related quality of life (HRQoL) is important to consider when treating persons with Parkinson’s disease (PwPD), and identifying the factors which most impact HRQoL is the first step to improve it. Poorer cognitive performance has been shown to be associated with poorer HRQoL in non-demented PwPD, but the relative contributions of specific cognitive domains, including attention (Lawson et al., 2016; Tang et al., 2020), executive function (Schiehser et al., 2009), memory (Vasconcellos et al., 2019) and language (Tang et al, 2020), are unclear. Military Veterans with PD presumably face these same risk factors, but also encounter additional challenges less likely experienced by civilian samples, such as combat exposure, PTSD, and adult traumatic brain injury (TBI). While there is robust research examining the relationship between HRQoL and cognition in non-military PwPD, the relationship between cognition and HRQoL considering military-relevant risk factors in Veterans with PD remains vastly understudied. Thus, the purpose of this study was to investigate the relationship between specific cognitive domains (i.e., memory, executive function, attention, and language) and HRQoL and the impact of military-specific risk factors on this relationship in non-demented Veterans with PD. Participants and Methods: 52 non-demented military Veterans diagnosed with PD completed comprehensive neuropsychological assessments and self-report questionnaires. Individual scores from cognitive tests were grouped into composite scores based on domain: Memory, Attention, Language, and Executive Function. Participants also completed the Parkinson’s Disease Questionnaire (PDQ-39) for HRQoL, Combat Exposure Scale (CES), and the PTSD Checklist (PCL-5). The Boston Assessment of TBI - Lifetime (BAT-L) was used to determine TBI status (25 with TBI, 27 without TBI) for all participants. Spearman correlations and multiple hierarchical regressions with backwards elimination controlling for significantly correlated variables (mood [depression], disease factors [disease duration], and Veteran-specific/oriented variables [PTSD]) were conducted. Results: Worse ratings of HRQoL (higher PDQ-39 scores) were significantly correlated with worse cognitive performance in all domains. When all four cognitive domains were included in the model, worse HRQoL was predicted solely by worse Memory performance (standardized 𝜷= -.219, p= .025) above and beyond relevant covariates, including PTSD (p= .002), depression (p= .062), and disease duration (p= .015), but not Attention, Executive Function, nor Language (all p’s > .58). Combat exposure (p= .082) and adult TBI status (p= .828) were not significantly correlated with PDQ-39 scores at the bivariate level and therefore, were not included in the regression analyses. Conclusions: Our results indicate that better memory performance, as opposed to attention, language, and executive function, is associated with better HRQoL in Veterans with PD above and beyond relevant demographics and characteristics. Additionally, disease duration and PTSD history are also significantly associated with HRQoL, while combat exposure and adult TBI status are not. Our study establishes memory as the most relevant cognitive domain, and of the miliary-related variables, PTSD as a critical component of HRQoL in Veterans with PD. These findings have important clinical implications. Cognitive rehabilitation with an emphasis on compensatory or restorative memory strategies and treatment for PTSD symptoms may be beneficial to improving HRQoL in Veterans with PD.

Poster

02/15/2024
08:00 am - 09:15 am
Room: Majestic Complex (Posters 61-120)

Poster Session 02: Aging | MCI | Neurodegenerative Disease - PART 1

Final Abstract #73

Cognitive and Military Predictors of Health-Related Quality of Life in Veterans with PD

Deyran Paredes, Research Service, VA San Diego Healthcare System, La Jolla, United States
Jennifer Adler, Research Service, VA San Diego Healthcare System, La Jolla, United States
Ashley Carrillo, Research Service, VA San Diego Healthcare System, La Jolla, United States
Lysette Desilva, Research Service, VA San Diego Healthcare System, La Jolla, United States
Ece Bayram, Department of Neurosciences, Movement Disorder Center, University of California, San Diego, San Diego, United States
Kristy Hwang, Department of Neurosciences, Movement Disorder Center, University of California, San Diego, San Diego, United States
Dawn Schiehser, Department of Psychiatry, University of California, San Diego, San Diego, United States

Category: Movement and Movement Disorders

Keyword 1: Parkinson's disease
Keyword 2: quality of life

Objective:

Health-related quality of life (HRQoL) is important to consider when treating persons with Parkinson’s disease (PwPD), and identifying the factors which most impact HRQoL is the first step to improve it. Poorer cognitive performance has been shown to be associated with poorer HRQoL in non-demented PwPD, but the relative contributions of specific cognitive domains, including attention (Lawson et al., 2016; Tang et al., 2020), executive function (Schiehser et al., 2009), memory (Vasconcellos et al., 2019) and language (Tang et al, 2020), are unclear. Military Veterans with PD presumably face these same risk factors, but also encounter additional challenges less likely experienced by civilian samples, such as combat exposure, PTSD, and adult traumatic brain injury (TBI). While there is robust research examining the relationship between HRQoL and cognition in non-military PwPD, the relationship between cognition and HRQoL considering military-relevant risk factors in Veterans with PD remains vastly understudied. Thus, the purpose of this study was to investigate the relationship between specific cognitive domains (i.e., memory, executive function, attention, and language) and HRQoL and the impact of military-specific risk factors on this relationship in non-demented Veterans with PD.

Participants and Methods:

52 non-demented military Veterans diagnosed with PD completed comprehensive neuropsychological assessments and self-report questionnaires. Individual scores from cognitive tests were grouped into composite scores based on domain: Memory, Attention, Language, and Executive Function. Participants also completed the Parkinson’s Disease Questionnaire (PDQ-39) for HRQoL, Combat Exposure Scale (CES), and the PTSD Checklist (PCL-5). The Boston Assessment of TBI - Lifetime (BAT-L) was used to determine TBI status (25 with TBI, 27 without TBI) for all participants. Spearman correlations and multiple hierarchical regressions with backwards elimination controlling for significantly correlated variables (mood [depression], disease factors [disease duration], and Veteran-specific/oriented variables [PTSD]) were conducted.

Results:

Worse ratings of HRQoL (higher PDQ-39 scores) were significantly correlated with worse cognitive performance in all domains. When all four cognitive domains were included in the model, worse HRQoL was predicted solely by worse Memory performance (standardized 𝜷= -.219, p= .025) above and beyond relevant covariates, including PTSD (p= .002), depression (p= .062), and disease duration (p= .015), but not Attention, Executive Function, nor Language (all p’s > .58). Combat exposure (p= .082) and adult TBI status (p= .828) were not significantly correlated with PDQ-39 scores at the bivariate level and therefore, were not included in the regression analyses.

Conclusions:

Our results indicate that better memory performance, as opposed to attention, language, and executive function, is associated with better HRQoL in Veterans with PD above and beyond relevant demographics and characteristics. Additionally, disease duration and PTSD history are also significantly associated with HRQoL, while combat exposure and adult TBI status are not. Our study establishes memory as the most relevant cognitive domain, and of the miliary-related variables, PTSD as a critical component of HRQoL in Veterans with PD. These findings have important clinical implications. Cognitive rehabilitation with an emphasis on compensatory or restorative memory strategies and treatment for PTSD symptoms may be beneficial to improving HRQoL in Veterans with PD.