Applied cognitive strategy behaviours in people with parkinson's disease during daily activities: A cross-sectional study.

Abstract

To explore the use of applied cognitive strategy behaviours during performance of daily activities in people with Parkinson's disease. Quantitative cross-sectional design. A total of 190 persons living at home with non-dementing Parkinson's disease were videotaped while performing a self-chosen activity in their natural environment. The videotaped performance was scored using the "Perceive, Recall, Plan and Perform System of Task Analysis" to measure: (i) performance mastery; and (ii) effective use of 34 cognitive strategy behaviours covering: attention and sensory processing (Perceive), accessing task-related knowledge (Recall), response planning and evaluation (Plan) and performance control (Perform). Mean performance mastery and a hierarchy of least to most effective applied cognitive strategy behaviours were determined for the total group and for 2 sub-groups based on disease severity. A multi-faceted Rasch model was used for data analysis. Mean performance mastery was 56% (standard deviation (SD) 28). Least efficient cognitive strategy behaviours were those used for planning, evaluating and controlling performance and most efficient strategies were those used for sensory discrimination and recalling factual information. More advanced disease indicated less efficient use of applied cognition. The results suggest that the efficiency of applied cognitive strategy behaviours is compromised in a certain pattern in people with Parkinson's disease, and that it declines with disease progression.