Profile of Independence in Activities of Daily Living Among Patients With Parkinson's Disease: A Retrospective Observational Study.

Abstract

Importance: Persons with Parkinson's disease (PD) become more dependent in activities of daily living (ADL) as the disease progresses. Occupational therapy practitioners aware of the stages of PD can design interventions to promote and maintain occupational performance.

Objective: To evaluate the ADL independence and dependence profiles of patients with PD on the basis of disease stages.

Design: Retrospective observational study.

Setting: Hospital in Japan.

Participants: Patients with PD (N = 209; 75 men and 134 women), with a mean age of 73.3 yr (SD = 7.7).

Outcomes and measures: The Hoehn and Yahr (H-Y) stage was used to determine patients' disease severity. The Barthel Index (BI) was used to determine independence in performing ADLs.

Results: In the H-Y Stage 2 group, the prevalence of independence in mobility and stairs was low, whereas that in other ADLs was high. In the H-Y Stage 3 group, more than half of the patients had limitations in bathing, mobility, and navigating stairs, although most patients remained independent in other ADLs. In the H-Y Stage 4 group, more than half of the patients required assistance with most ADLs, except feeding and bowel control. In the H-Y Stage 5 group, the prevalence of independence during feeding and grooming was relatively high.

Conclusions and relevance: Dependence in ADL domains differs by PD stage, with direct implications for occupational therapy intervention. Plain-Language Summary: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor symptoms and nonmotor symptoms. The disease progression can gradually affect activities of daily living (ADLs), which can lead to decreased independence and quality of life as well as increased caregiver distress. This study evaluated the ADL independence and dependence of patients with PD based on each patient's disease stage. The study found that ADL dependence differs based on the PD stage (mild, moderate, severe), with direct implications for occupational therapy intervention. Occupational therapists can design interventions to improve and maintain the occupational performance of people with PD. Interventions that target ADLs should be based on the patient's PD stage.