Dementia and functional decline in patients with Parkinson's disease

Stella, Florindo; Banzato, Cláudio E. M.; Quagliato, Elizabeth Maria Aparecida Barasnevicius; Viana, Maura Aparecida; Christofoletti, Gustavo

doi:10.1590/s1980-57642009dn20200004

Cited by 5 publications

(4 citation statements)

References 32 publications

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“…Out of the four study groups, non-ambulatory PwP with cognitive disability have the most severe disabilities in all domains of daily functioning. These findings are consistent with previous findings, indicating that functional decline in PD results from motor impairment and is likely aggravated by concomitant cognitive impairment (23)(24)(25). Furthermore, based on the results of our non-parametric analysis, we hypothesize that as a determinant of functional disability, cognition is likely to be more important than ambulation status in later stages of PD.…”

Section: Discussionsupporting

confidence: 92%

Effect of Cognitive Disability and Ambulation Status on Functioning in Moderate-to-Advanced Parkinson Disease

Wang

Chan

et al. 2020

Front. Neurol.

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Background: As the disease progresses to moderate to advanced stages, people with Parkinson's disease (PwP) are likely to have various degrees of disability due to the motor and non-motor symptoms, such as ambulatory difficulty and cognitive impairment. The objective of this study was to investigate the impact of cognition and ambulation status on the functioning and disability of PwP using the World Health Orgnaization Disability Assessment Schedule 2.0 (WHODAS 2.0). Materials and Methods: A group of 10,581 PwP with Hoehn and Yahr Staging 3 and above were collected from a database of disability evaluation and functional assessment using the Taiwan Data Bank of Persons with Disability between July 2012 and October 2018. WHODAS 2.0 was administered and all PwP were grouped based on their ambulatory status, which was assessed by 3-m back and forth walk and cognitive ability, assessed by WHODAS 2.0 first domain with cutoff level at 58. Results: Non-ambulation and cognitive disability contributed independently to disability in all aspects of WHODAS 2.0 survey, including self-care, getting along with others, performing life activities and participation in society. Compared to ambulation status, cognitive disability had a greater negative impact on functioning in all aspects. Conclusion: Cognitive disability was associated with greater disability in moderate to advanced PwP than non-ambulatory status. The results of this study may indicate that cognition preservation is essential to ameliorate functional impairment and disability in moderate to advanced PwP.

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Section: Discussionsupporting

confidence: 92%

Effect of Cognitive Disability and Ambulation Status on Functioning in Moderate-to-Advanced Parkinson Disease

Wang

Chan

et al. 2020

Front. Neurol.

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“…Thus, dementia indeed contributed to a greater functional decline in ADL performance for PwP. Stella et al compared the functional decline in PwP with and without dementia and also found that those with dementia had a greater functional impairment [15]. The functional decline in PD was also shown to be correlated with a cognitive decline similar to AD [31], which explains why PwP with dementia exhibited a greater functional impairment than those without dementia but with the same motor deficits did.…”

Section: Discussionmentioning

confidence: 99%

“…The motor symptoms and NMSs are deleterious to the activities of daily living (ADL) of PwP and thus may accelerate their functional decline through a vicious cycle. For instance, in PwP with dementia, prominent executive dysfunction and psychosis are associated with a greater disability [15]. ADL impairment results in an increase of caregiver burden and economic loss.…”

Section: Introductionmentioning

confidence: 99%

Dementia-Related Functional Disability in Moderate to Advanced Parkinson’s Disease: Assessment Using the World Health Organization Disability Assessment Schedule 2.0

Chen

Hong

et al. 2019

IJERPH

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Dementia is a common nonmotor condition among people with moderate or advanced Parkinson’s disease (PD). Undoubtedly, profound motor symptoms cause remarkable impairment in daily activities; however, dementia-related disabilities have not been thoroughly investigated, especially not with consideration of differences according to sex. The present study used the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to compare the functional disability between men and women with PD (PwP) with and without dementia. This study employed a registry of disability evaluation and functional assessment using the Taiwan Data Bank of Persons with Disability between July 2012 and October 2018. To investigate dementia-related disability in PwP, 1:1 matching by age and Hoehn-Yahr stage was conducted, which resulted in the inclusion of 1605 study participants in each group. The present study demonstrated that among the six major domains of WHODAS 2.0, the section of “Getting alone with others” was significantly worse in both genders of PwP with dementia; however, a greater disability in fulfilling activities of daily living was only noted in male PwP with dementia but not in their female counterparts. Neither the inability to provide self-care nor participation were significantly different between the sexes. Our findings suggested that deteriorating social relationships were a dementia-related disability in all PwP at the moderate and advanced disease stages. Regarding the performance of activities of daily living, deterioration was related to dementia only in male PwP. Such disabilities could indicate cognitive impairment in people with moderate or advanced PD and could be used as an indicator for the early detection of dementia in PwP by healthcare professionals through the easier functional assessment of the WHODAS 2.0.

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“…Trata-se de uma doença progressiva, de evolução crônica, de etiologia idiopática e altamente incapacitante. Os sintomas são geralmente percebidos em torno de 60 anos de idade, sendo os homens mais afetados do que as mulheres 10,11 .…”

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Aspectos físicos e mentais na qualidade de vida de pacientes com doença de Parkinson idiopática

et al. 2009

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RESUMO: A doença de Parkinson (DP) é um distúrbio crônico e progressivo, caracterizado pela degeneração de neurônios dopaminérgicos da substantia nigra mesencefálica. A lesão das vias subcorticais, em especial a nigro-estriato-palidal, é particularmente comum e ocasiona uma série de sinais e sintomas incapacitantes. O objetivo deste trabalho foi analisar a qualidade de vida (QV) relacionada à saúde de sujeitos com DP e compará-la à de indivíduos controles saudáveis. Foram avaliados 40 sujeitos com idades entre 61 e 83 anos, de ambos os sexos, que foram divididos em dois grupos: grupo Parkinson (n=21), composto por sujeitos com DP idiopática, e grupo controle (n=19), de indivíduos sem distúrbios neurodegenerativos. Para a coleta de dados, foi utilizada a versão brasileira do questionário Brasil SF-36. Os resultados foram analisados estatisticamente, com nível de significância fixado em 1%. Os sujeitos do grupo Parkinson apresentaram escores significativamente mais baixos do que os do grupo controle, tanto no domínio físico quanto no mental, medidos pelo SF-36. Essa baixa QV provavelmente é explicada pela co-ocorrência de fenômenos neurodegenerativos e do sofrimento psíquico gerado pela doença e pelo estigma que ela produz. Abordagens interdisciplinares devem ser estimuladas a pacientes com DP, com o objetivo de melhorar sua qualidade de vida e postergar o declínio físico e mental inerente às condições degenerativas. DESCRITORES: Doença de Parkinson; Perfil de impacto da doença; Qualidade de vida ABSTRACT: Parkinson disease (PD) is a chronic and progressive disorder characterized by degeneration of dopaminergic neurons in the mesencephalic substantia nigra. Lesions involving the subcortical pathways, especially the nigro-striato-pallidal path, are particularly common, and cause a series of disabling signs and symptoms. The aim of this study was to analyse the quality of life of individuals with PD and compare them to healthy controls. Forty subjects of both sexes were analysed, aged between 61 and 83, divided into two groups: Parkinson group (n=21), made up of individuals with idiopathic PD; and control group (n=19), of subjects with no neurodegenerative disorder. Data were collected by means of the Brazilian version of the Short Form-36 (SF-36) questionnaire. Data were statistically analysed and the significance level set at 1%. PD group subjects had SF-36 scores significantly lower than control ones, both in physical and mental health domains. Such low, perceived health-related quality of life among PD subjects is probably due to the co-occurrence of the neurodegenerative phenomena and the psychological distress provoked both by the disease itself and the stigma assigned to it. Interdisciplinary approaches should be encouraged to improve the quality of life of PD patients, aiming at postponing the physical and mental decline inherent to this degenerative condition.

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Dementia and functional decline in patients with Parkinson's disease

Cited by 5 publications

References 32 publications

Effect of Cognitive Disability and Ambulation Status on Functioning in Moderate-to-Advanced Parkinson Disease

Effect of Cognitive Disability and Ambulation Status on Functioning in Moderate-to-Advanced Parkinson Disease

Dementia-Related Functional Disability in Moderate to Advanced Parkinson’s Disease: Assessment Using the World Health Organization Disability Assessment Schedule 2.0

Aspectos físicos e mentais na qualidade de vida de pacientes com doença de Parkinson idiopática

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