Loss of ability to work and ability to live independently in Parkinson’s disease

Abstract

Objective Ability to work and independent living capacity are of particular concern for patients with Parkinson’s disease (PD). We utilized a series of PD patients able to work or live independently at baseline, and evaluated potential risk factors for the two separate outcomes of loss of ability to work and loss of ability to live independently. Methods The series was comprised of 495 PD patients followed prospectively. Ability to work and ability to live independently were based on clinical interview and examination. Cox regression models adjusted for age and disease duration were used to evaluate associations of baseline characteristics with loss of ability to work and loss of ability to live independently. Results Higher UPDRS dyskinesia score, UPDRS instability score, UPDRS total score, Hoehn and Yahr stage, and presence of intellectual impairment at baseline were all associated with increased risk of future loss of ability to work and loss of ability to live independently (P≤0.0033). Five years after initial visit, for patients ≤70 years of age with a disease duration ≤4 years at initial visit, 88% were still able to work and 90% to live independently. These estimates worsened as age and disease duration at initial visit increased; for patients >70 years of age with a disease duration >4 years, estimates at 5 years were 43% and 57%, respectively. Conclusions The information provided in this study can offer useful information for PD patients in preparing for future loss of ability to perform activities of daily living.

Physical therapy and occupational therapy in Parkinson's disease

“…Inevitably, PD restricts PwP in participating in meaningful activities related to work, leisure or community and social life [33][34][35][36][37]. Many activities require too much time and effort, cause embarrassment, or are considered too dangerous by those close to them [38].…”

A systematic review of loss of independence in Parkinson’s disease

“…Thirteen studies were hospital based [5,10,[12][13][14][15][16][17][18][19][20][21][22] and one was community based [11]. Nine studies were retrospective [5,12,14,15,17,18,[20][21][22] and five were prospective [10,11,13,16,19]. One study was published before the introduction of levodopa [5], three straddled its introduction [15,18,20] and the rest were carried out when levodopa was widely available [10-14, 16, 17, 19, 21].…”

“…Four inception cohorts [5,11,12,16,19] and nine noninception studies [10,[13][14][15][17][18][19][20][21] reported risk of dependency ( Fig. 2 and online resource 2).…”

Preditores Do Desempenho No Teste De Alcance Funcional Em Pessoas Com Doença De Parkinson

“…A doença de Parkinson (DP) é uma desordem neurológica crônica e progressiva, associada a declínio funcional 1,2 . Atualmente, é a segunda desordem neurodegenerativa de maior prevalência no mundo, afetando de 0,5 a 1% da população com idade entre 65 e 69 anos, sendo que a prevalência aumenta com a idade, chegando a 3% na população com 80 anos de idade [3][4][5] .…”

“…No Brasil, os dados epidemiológicos apontam que 3,3% da população brasileira com mais de 64 anos é acometida pela doença 6 . A DP é decorrente da morte progressiva dos neurônios dopaminérgicos da substância negra, que ocasiona comprometimentos motores e cognitivos que reduzem a funcionalidade e é caracterizada pela presença de sinais e sintomas motores de tremor de repouso, rigidez articular, bradicinesia e instabilidade postural 1,2,7 . A instabilidade postural representa um dos sintomas motores mais incapacitantes da DP, sendo um dos principais fatores de risco de queda 8,9 .…”