Abstract
ABSTRACT.Cognitive impairment is common in patients with Parkinson’s disease (PD), and evaluation of functional abilities is crucial for diagnosis of dementia.Objective:We evaluated differences between direct and indirect functional assessment methods to evaluate functional abilities in PD patients.Methods:We evaluated 32 patients with PD and suspected mild dementia using direct and indirect assessment methods.Results:There was a significant difference between the scores of direct and indirect methods of assessment. Patients and close informants usually overestimated their abilities in many ADL. However, all functional assessment tools used in this study had a relatively good accuracy to predict abnormal performance in a global cognitive scale. Patients with normal cognition according to scores in a global cognitive scale may have some functional impairment in ADL. Direct Assessment of Functional Ability (DAFA) scores correlated linearly with scores in global cognitive scales, and especially with scores in the domains of memory and concentration.Conclusion:Patients and close informants usually overestimate their instrumental abilities in ADL. The direct assessment of daily functioning was more reliable than indirect tools to assess functional losses in patients with PD. Finally, some patients with PD but no dementia may present functional losses in ADL.
Highlights
Cognitive impairment is common in patients with Parkinson’s disease (PD), and evaluation of functional abilities is crucial for diagnosis of dementia
Our study assessed a small but representative sample of PD patients presenting with cognitive performance bordering on a diagnosis of dementia
Considering the hypothesis that patients with PD evolve in a gradual process of cognitive loss from the stage of mild cognitive impairment (MCI) to dementia, our patients were close to a transition point between these two cognitive states
Summary
Cognitive impairment is common in patients with Parkinson’s disease (PD), and evaluation of functional abilities is crucial for diagnosis of dementia. Direct Assessment of Functional Ability (DAFA) scores correlated linearly with scores in global cognitive scales, and especially with scores in the domains of memory and concentration. O comprometimento cognitivo é comum em pacientes com doença de Parkinson (DP), e a avaliação das habilidades funcionais é crucial para o diagnóstico de demência. Objetivo: Avaliamos diferenças entre os métodos de avaliação funcional direta e indireta para avaliar habilidades funcionais em pacientes com DP. De acordo com os escores em uma escala cognitiva global, podem apresentar algum comprometimento funcional nas AVD.
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