The accuracy of self-reported driving behaviors, particularly in relation to real-world risky driving in realistic settings over time, remains unclear. This study aimed to examine whether self-reports remain consistent over time, whether they predict real-world driving behaviors, and whether that relationship changes over time. Self-reported driving behaviors included a global rating score of driving ability and four components of the Driver Behavior Questionnaire (lapses, errors, ordinary violations, and aggressive violations). At three separate timepoints [baseline (N = 47), 6-month (N = 43), and 12-month (N = 38)], we obtained these self-ratings along with real-world risky behaviors recorded using the Lytx video telematics platform over a 28-day period. Linear mixed effects models were used to examine whether self-reported driving behaviors changed over time and whether they predicted real-world driving. Neither self-reported nor objective driving behaviors significantly changed over time. Aggressive violations, specifically at the 6-and 12-month follow-up visits, and ordinary violations at the 12-month visit significantly predicted real-world risky driving. Consistent with the literature, these findings indicate that self-reported driving behaviors do not change over time. Aggressive violations, reported at follow-up visits, may be the most indicative of overall real-world risky driving. Their value at follow-up visits specifically may be because participants are more attuned to these behaviors after an initial period of observation. Additionally, aggressive violations are commissive behaviors with a strong negative emotional valence, which could cause them to be remembered better than omissive behaviors and those with a more neutral emotional valence. These results can potentially influence driving assessments and interventions.

INTRODUCTION:Difficulties in executive functioning (EF) are common in PD; however, the relationship between subjective and objective EF is unclear. Understanding this relationship could help guide clinical EF assessment. This study examined the relationship between subjective self-reported EF (SEF) and objective EF (OEF) and predictors of SEF-OEF discrepancies in PD. METHOD:One-hundred and sixteen non-demented PD participants completed measures of OEF (i.e. problem-solving, cognitive flexibility, inhibition, and working memory) and SEF (Frontal Systems Behavior Scale-Self Executive Dysfunction Subscale). Pearson bivariate correlations and linear regressions were performed to examine the relationship between SEF and OEF and the non-motor symptoms (e.g. mood, fatigue), demographic, and PD characteristic (e.g. MCI status) predictors of discrepancies between OEF and SEF (|OEF minus SEF scores|). Correlates of under-, over-, and accurate-reporting were also explored. RESULTS:Greater SEF complaints and worse OEF were significantly associated (β =.200, p = .009) and 64% of participants accurately identified their level of OEF abilities. Fewer years of education and greater symptoms of depression, anxiety, and fatigue significantly correlated with greater discrepancies between OEF and SEF. Fatigue was the best predictor of EF discrepancy in the overall sample (β = .281, p = .022). Exploratory analyses revealed apathy and fatigue associated with greater under-reporting, while anxiety associated with greater over-reporting. CONCLUSIONS:SEF and OEF are significantly related in PD. Approximately 64% of non-demented persons with PD accurately reported their EF skill level, while 28% under-reported and 8% over-reported. SEF-OEF discrepancies were predicted by fatigue in the overall sample. Preliminary evidence suggests reduced apathy and fatigue symptoms relate to more under-reporting, while anxiety relates to greater over-reporting. Given the prevalence of these non-motor symptoms in PD, it is important to carefully consider them when assessing EF in PD.

Objective: Frontal behaviors (i.e., executive dysfunction, disinhibition, apathy) are common in Parkinson's disease (PD). However, it is unclear if patient and informant reports of patient frontal behaviors are in agreement over time. Method: Sixty-two PD patients without dementia and their informants (87% spouses/partners) completed the self- and informant-versions of the Frontal Systems Behavior Scale at baseline and 2-year follow-up. Dyad ratings were compared and predictors of behavior ratings were examined. Results: Patient and informant reports at baseline and follow-up were in agreement, with significant increases in overall frontal behaviors, executive dysfunction, and apathy. Higher levels of baseline patient depression and caregiver burden predicted decrements in patient-reported executive function; worse patient cognition at baseline predicted worsening apathy as rated by informants. Conclusions: PD patients and their informants are concordant in their ratings of worsening frontal behaviors over time. Targeting patient depression, cognition, and caregiver burden may improve decrements in frontal behaviors (executive dysfunction and apathy) in PD.

Care partners who provide informal care to individuals with Parkinson's disease (PD) report higher levels of burden and depression; however, longitudinal research on these symptoms is scarce. The current study assessed changes in care partner burden and depression, and patient and care partner predictors of these symptoms over time. Such knowledge may provide important information for assessment and treatment of depression and burden in care partners of individuals with PD.

Dementia is a growing global challenge that is difficult to treat. Pharmaceutical treatment approaches have had limited success, leading to an increased focus on nonpharmaceutical approaches to the treatment of dementia. A clinical pilot study was performed to evaluate whether ReminX digital therapeutic software, based on reminiscence therapy, has the potential to improve emotional functioning in patients with Alzheimer's disease and related dementias. ReminX allows the uploading of pictures and narration to create slideshow stories depicting important moments in the patient's life. Fourteen patients were evaluated in their home, and their emotional health was assessed both before and after using ReminX. Results indicated that patients reported significantly less anxiety, depression, and overall emotional distress after having viewed their story. Furthermore, patient's caregivers also reported that the patient appeared less emotionally distressed. The effect sizes for the significant results ranged from 0.76 to 0.91. These effect sizes, which were larger than anticipated, suggest that digitally-delivered reminiscence therapy can have an immediate and positive impact on emotional functioning in patients with dementia. In addition, the accessibility, scalability, and ease of use of the software platform suggests that this technology holds great promise as a product for use in both the home and senior care settings.

BackgroundThe Geriatric Depression Scale (GDS) is recommended for screening depression in individuals with Parkinson's disease (PD). Empirical evidence, however, is limited regarding its validity and factor structure in PD. Thus, the current study sought to evaluate the convergent and divergent validity of the GDS, as well as the structure and validity of the derived factors.MethodNondemented individuals with PD (n = 158) completed the GDS‐30, and items were subjected to a principle component analysis. Geriatric Depression Scale total and factor scores were correlated with depression items from the Movement Disorder Society Unified Parkinson's disease Rating Scale (MDS‐UPDRSd) and Hamilton Rating Scale for Depression (HAMDd), as well as with the Apathy Scale (AS), State‐Trait Anxiety Inventory (STAI), Modified Fatigue Impact Scale (MFIS), Parkinson's disease Sleep Scale, and a Subjective Cognitive Function composite score.ResultsThe GDS total score was strongly correlated with divergent neuropsychiatric measures (AS, r = 0.57; STAI, r = 0.66; MFIS, r = 0.60), while only moderately correlated with convergent measures (MDS‐UPDRSd, r = 0.36; HAMDd, r = 0.32; Ps < 0.05). Linear regression analyses revealed standardized measures of anxiety, apathy, and fatigue independently predicted the GDS total score, while depression items (MDS‐UPDRSd and HAMDd) failed to reach significance. Three independent factors were identified: Anxiety, Apathy, and Fatigue. These factors were significantly predicted by their respective convergent measures.ConclusionsTaken together, our findings suggest that the GDS and its subscales appear to primarily measure anxiety, apathy, and fatigue in PD, or alternatively, these symptom dimensions may be predominant in PD‐depression. Future research with clinically diagnosed samples is needed to confirm these initial findings.

This study examined the impact of a digital therapeutic software system on emotional functioning in a group of patients with Dementia. The digital therapeutic software is based on Reminiscence Therapy and allows the uploading of pictures and narration to create slideshow stories depicting important moments in the patient’s life. Patients were evaluated in their home and the initial evaluation consisted of patients responding to questionnaires assessing their level of depression, anxiety, and overall level of emotional distress. Patients’ caregivers were also asked to rate the patient’s level of emotional functioning. After the initial assessment, and on the same day, patients and their caregivers were instructed on how to use the digital therapeutic software and created a slideshow. Patients then viewed the slideshow and immediately after were re-assessed using the same set of questionnaires as prior to the viewing. Results indicated that patients reported significantly less anxiety, depression, and overall emotional distress after having viewed their story. Furthermore, patient’s caregivers also reported that the patient appeared less emotionally distressed. The effect sizes for the significant results were typically large and ranged from 0.76 to 0.91 (effect sizes are used to quantify the magnitude of a statistical effect, with 0.50 typically being viewed as a moderate effect and 0.80 being considered a large effect of an intervention). These effect sizes, which were larger than anticipated, suggest that digital therapeutic software can have an immediate and positive impact on emotional functioning in patients with Dementia. In addition, the accessibility and ease of use of the software system suggests that this technology holds great promise for bringing important aspects of Reminiscence Therapy to patients with Dementia who are suffering from various mood symptoms.