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Clinical Issues

Informant Perceptions of the Cause of Activities of Daily Living Difficulties in Parkinson’s Disease

&
Pages 82-94
Received 04 Sep 2015
Accepted 22 Dec 2015
Published online: 03 Feb 2016

Objective: Individuals with Parkinson’s disease (PD) can have difficulties with activities of daily living (ADL) that stem from cognitive, motor, or affective manifestations of the disease. Accurately attributing ADL difficulty specifically to cognitive decline is critical when conducting a neuropsychological evaluation of a person with PD. Informant description of ADL performance is frequently used for this purpose, but there has been little work assessing informants’ ability to attribute ADL dysfunction to a specific symptom source in PD. Method: Fifty community dwelling individuals with PD completed cognitive, motor, and affective measures. A knowledgeable informant completed an ADL scale that asked about degree and perceived source of difficulty (cognitive, motor, affective) for each task. Results: Informants indicated that motor dysfunction was the most common source of ADL difficulty, but the informants viewed difficulty with certain tasks, such as financial management, as particularly related to cognitive dysfunction. Informant reports of the source of ADL dysfunction (cognitive, motor, affective) were consistent with clinical measures of those specific dysfunctions. ADL dysfunction attributed to cognition specifically (χ2 = 9.80, p = .01) was higher in those with measurable cognitive impairment. Conclusions: Informant reports of the sources of ADL dysfunction correlate with clinical measures of these symptoms, suggesting that informants may provide useful clinical information about the cause of ADL dysfunction in persons with PD.

Acknowledgments

We appreciate the support of patient’s and family members of the local PD support groups for their engagement in this project. We also appreciate the work of Melissa Ainslie, Research Coordinator and Outreach Coordinator for the PMDC.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Plummer Movement Disorders Center at Baylor Scott & White Health to the first author.

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