Objective: This study aims to investigate the association between the hand fine motor performance with the cognitive dysfunction in people with moderate and severe PD.

Background: Patients with Parkinson’s disease (PD) suffer from progressive motor dysfunction across disease progression. Other than motor disability, patients also experience non-motor symptoms (NMSs), which are sometimes even more disturbing than motor disturbance. Cognitive dysfunction is one of the most devastating NMSs. An earlier and easier detection on cognitive disability is crucial. It had been noticed that among people with dementia, the performance of hand fine motor movement is associated with the severity of cognitive dysfunction.

Method: The study analysed the Taiwan Data Bank of Persons with Disability and a total of 3,440 patient with moderate and severe PD (Hoehn and Yahr Stage 3-5) between July 2012 to October 2018 were included. World Health Organization Disability Assessment Schedule (WHODAS) 2.0 was assessed in all of them. Among all the patients with moderate to severe PD, 17.8%(612) of them were diagnosed with dementia as well. Hands fine motor performance in WHODAS (8.1 holding a pen, 8.2 buttoning and 8.3 tying a knot) was evaluated in all of these two groups of patients (moderate to severe PD with or without dementia).

Results: All three hands fine movement performance were significantly worse in patients with PD dementia. After adjusting the age, sex and disease severity, WHODAS 8.1 (holding a pen) and 8.3 (tying a knot) were significantly associated with the presence of dementia. The presence of any disability in either one of these two tasks was sensitive to the presence of dementia (sensitivity=76.5%, specificity=72.5%), especially for those who were equal or above 75 years old.

Conclusion: Specific tasks of hands fine movement were associated with the presence of dementia among people with moderate to severe PD. By using these simple hands fine motor tasks as screening test at the outpatient department, it would be sensitive to identify the dementia in patients with moderate to severe PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hand-fine-motor-performance-capacity-is-associated-with-the-cognition-in-people-with-moderate-to-advanced-parkinsons-disease/