Objective: The purpose of this study was to identify among several motor, cognitive and mental measures which has higher power to predict the reduction in daily living activities (DLA) independence.

Background: The independence in daily living activities (DLA) is a crucial key to avoid the decrease in quality of life of the people living with Parkinson’s disease (PD). Among the motor, cognitive and mental disruption associated to PD, there is no consensus about which of them has higher power to predict the reduction in DLA independence.

Methods: Participated this study 236 people with idiopathic PD, with 68.2+8 years of age, in stage I-V of disease evolution according to Hoehn and Yahr (H&Y) classification. The participants were evaluated in ON period of dopaminergic medication, using the Unified Parkinson’s Disease Rating Scale (UPDRS)-section II to assess the DLAs’ independence, and section III to assess the severity of motor symptoms, the Mini-Balance Evaluation Systems Test (MiniBest). Falls Self-Efficacy Scale (FES) to assess balance and the fear of falling, Freezing of Gait Questionnaire (FOG- Q) to assess the presence of freezing, Timed Up and Go test (TUG) to assess the functional mobility, Ten Meter Walk Test (10 MWT) to assess the gait performance, Six-minute Walk Test (6MWT) and 5XT to assess physical capacity, The Nine Hole Peg Test (9HPT) and manual strength (MS) to assess strength and manual function, Montreal Cognitive Assessment (MoCA) to assess cognition and the Geriatric Depression Scale (GDS) to assess depression.

Results: The statistical analysis showed a significant correlation of the UPDRS-section III, GDS, FES, FOG-Q, 9HPT, 5XT, 6MWT, MiniBest and TUG with UPDRS-section II (p<.05). However, the multiple regression model showed that only UPDRS-section III is able to predict the UPDRS-section II scores ( R= .67; R²= .45; Adjusted R²= .45; p<.000001). After the exclusion of UPDRS section III of regression model, only the scores in GDS was able to predict the scores in UPDRS-section II (R= .33; R²= .10; Adjusted R²= .10; p<.00001).

Conclusions: As expected, the severity of motor symptoms is key point to predict the decrease in DLA independence. However, excluding this evaluation, the level of humor state showed the higher power to predict the DLA decrease than disruption in cognition, balance and gait, usually referred as important aspect for DLA independence. Thus, the interprofessional care to treat the motor and mental aspects is fundamental to avoid the decrease in DLA independence in people with PD.

References: ROSIŃCZUK, J.; KOŁTUNIUK, A. The influence of depression, level of functioning in everyday life, and illness acceptance on quality of life in patients with Parkinson’s disease: a preliminary study. Neuropsychiatr Dis Treat. vol 13, pag 881–887, march 2017. Bugalho, P. et al. Non-Motor symptoms in Portuguese Parkinson’s Disease patients: correlation and impact on Quality of Life and Activities of Daily Living. Sci. Rep. vol 6, august 2016.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-severity-of-motor-symptoms-and-depression-are-the-higher-predictor-for-the-decrease-in-daily-living-activities-independence-in-people-with-parkinsons-disease/