Association Between Self-assessed Attention and Objective Neuropsychological Tests in Parkinson Disease

Abstract

To examine the relationship between self-assessed attentional skills and objective neuropsychological measures of attention in Parkinson disease (PD) and controls. The reliable self-assessment of one's own cognitive skills and deficits is an important but difficult task, especially in a chronic neurological condition like PD. Theories point out that brain structures involved in a realistic self-appraisal might be affected in PD. No study directly examined the association between self-assessed attentional skills and objective neuropsychological measures of attention in PD. We applied a case control design with 54 participants in the PD group and 54 healthy controls. PD patients and controls completed questionnaires on depression and self-assessed attention and were examined with computerized tests of attention. PD patients differed from controls in subjective and objective assessment of attention. Depression and self-assessed attention share a significant amount of variance, but are unrelated to objective measures of attention in both groups. In PD patients, there are no associations between functional outcome and objective and subjective measures of attention. Conscious reports in PD patients and controls are based on different processes rather than actual attentional performance. These processes are not differentially affected in PD. Nevertheless, patients' self-assessments are not an accurate indicator of their level of objective attentional functioning. Without a definite validity criterion, it cannot be decided whether the objective or subjective assessment of attention is more valid. Therefore, a multidimensional approach integrating different sources of information is most adequate in the assessment of attentional capacities and their meaning for everyday life in PD patients.