Objective: Explore and compare the associations of upper extremity function and global cognitive score to impairment of instrumental activities of daily living (IADLs) in people with Parkinson’s Disease (PwPD).

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder impacting motor control, cognition, and psychosocial functioning. Neurorestorative therapy is not available, so symptom management is the goal of medical and surgical interventions. The manifestations of disease contributing to real-world impairment of function may not be easily appreciated on routine examination. PD movement related cardinal symptoms, such as resting tremor, bradykinesia, and rigidity tend to be the primary features of treatment focus, but cognitive changes may also contribute to functional impairment. Cognitive impairment in PwPD might not be recognized in routine care and real-world impact might be under-recognized.

Method: Retrospective review of data collected in routine care of PwPD that were evaluated by multidimensional computerized cognitive assessment battery (CAB) and completed patient reported outcomes (PROs) of interest: Lawton- Brody: Instrumental Activities of Daily Living Scale (IADLs) and the Neuro-QoL Upper Extremity Function (Fine Motor, ADL)-Short Form (UE). Cognitive domains collected were: Memory (MEM), Executive Function (EF), Visual Spatial (VS), Information Processing (IP), Verbal Function (VF), Attention (ATT) as well as a Global Cognitive Summary Score (GCS). Significance was defined as p<0.05.

Results: 86 PwPD, average age 73+/-9, 65% male. The relationship of PRO-IADL to CAB-GCS was significant (p<0.05, r² = 0.37), as was the relationship of PRO-IADL to Neuro-QoL-UE (p<0.05, r² = 0.36).

Conclusion: Real world impact in PwPD extends beyond cardinal motor manifestations. Cognitive impairment in PwPD can impact IADLs. Multi-domain CAB provides added value information about disease impact that cannot be obtained by routine examination. Cognitive function manifestations of PD can vary in degree and combination across multiple domains and result in a multifactorial impairment of function.  Further studies will evaluate this impact to enhance care and provide an opportunity for proactive recognition and intervention of patient centric treatment needs.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-cognitive-function-exploration-of-the-relation-of-multi-domain-computerized-cognitive-testing-and-iadl-instrumental-activities-of-daily-living-and-neuro-qol-upper-extre/