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

Frontiers in Neurology

Lung Chan¹  Dean Wu¹  Chien Tai Hong¹  Chen Yu Wang²  Wen-Chou Chi³  Chia-Feng Yen⁶  Tsan-Hon Liou⁷  Hua-Fang Liao⁸ 

[1] Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;Department of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan;Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;Department of Public Health, Tzu Chi University, Hualien City, Taiwan;Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan;School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan;Taiwan Society of International Classification of Functioning, Disability and Health, TSICF, New Taipei City, Taiwan;

关键词: Parkinson's disease;    disability;    cognition;    ambulation;    WHODAS 2.0;   

DOI  :  10.3389/fneur.2019.01360

来源: DOAJ

【 摘 要 】

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 cut-off 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.

【 授权许可】

Unknown