Erin R. Foster; Instrumental Activities of Daily Living Performance Among People With Parkinson’s Disease Without Dementia. Am J Occup Ther 2014;68(3):353-362. doi: 10.5014/ajot.2014.010330.
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OBJECTIVE. To investigate the performance of cognitively demanding instrumental activities of daily living (IADLs) among people with Parkinson’s disease (PD) without dementia.
METHOD. Seventy-seven participants with PD and 57 participants without PD underwent standardized, performance-based IADL evaluation using the Performance Assessment of Self-care Skills. Activity performance was rated for independence, adequacy, and safety.
RESULTS. The PD group had lower independence and adequacy scores than the non-PD group for almost every activity. Medication management, shopping, and sharp utensil use were the activities most sensitive to group differences. In the PD group, older age, lower Mini-Mental State Examination scores, and decreased motor function were associated with poorer IADL performance.
CONCLUSIONS. People with relatively early and mild PD demonstrated measurable deficits in the performance of cognitively demanding IADLs. This work highlights the importance of using objective assessments of IADL function to detect early functional changes in people with PD.
Limitations in IADLs among clients with PD may go undetected by self- or informant-report measures.
Practitioners can use objective, performance-based measures to gain a more comprehensive understanding of IADL function in clients with PD.
Objective measures may enable the identification of early functional changes and, thus, more timely interventions for this population.
Strategies to support the performance of IADLs and other complex activities in the early stages of PD may allow people to maintain their independence, participation, and quality of life longer and may even slow the rate of functional decline.
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