Objective: To identify difficulties in cognitive strategy use observed in people with Parkinsons’s disease (PD) during performance of everyday activities.

Background: People use cognitive strategies in particular ways during daily activities. In PD the demand on cognitive strategies is high due to the need to compensate for motor and non-motor deficits, while the quality of application of these strategies may be affected by cognitive deficits. There is limited knowledge about the quality of cognitive strategy use in people with PD during task performance. The Perceive, Recall, Plan & Perform (PRPP) System of Task Analysis is a criterion referenced assessment to determine strengths and weaknesses in the application of 34 cognitive strategies during natural activity performance. (Chapparo &  Ranka, 2006; Van Keulen-Rouweler, 2017).

Methods: Cognitive strategy use of 190  persons with PD (Hoehn & Yahr Stages 1-4) was examined using multifaceted Rasch analysis of scores on the 34  PRPP items. The data were then examined for congruence with constructs of information processing underpinning the PRPP and with the stages of PD.

Results: The cognitive strategy use items in all four PRPP domains (attention and sensory processing, recall, planning and performance) showed congruence with information processing constructs. The hierarchical difficulty in applying cognitive strategies aligned with known PD cognitive symptoms. The results also revealed a step-wise decrease in effective cognitive strategy use that aligned with advancing disease (as classified by the Hoehn & Yahr scale).

Conclusions: People with PD have particular cognitive strengths and difficulties during activity performance that can be objectively observed, described and measured using the PRPP System of Task Analysis. The ability of persons with PD to use cognitive strategies during task performance deteriorates in a particular pattern as the disease progresses. These results guide the selection of interventions that target those cognitive strategies needed to successfully complete meaningful  tasks, routines and roles in daily life.

References: Chapparo C & Ranka, J. (2005) The PRPP System: Research Training Manual. Occupational Performance Network: School of Occupation & Leisure Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW Australia 1825

Van Keulen-Rouweler BJ, Sturkenboom IHWM, Kottorp A, Graff MJL, Nijhuis-van der Sanden MWG, Steultjens EMJ. The Perceive, Recall, Plan and Perform (PRPP) system for persons with Parkinson’s disease: a psychometric study.  Scand J Occup Ther 2017; 24 (1): 65-73.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-strategy-use-during-daily-activities-in-people-with-parkinsons-disease/