Predictors of functional dependency in Parkinson's disease

Area of Science:

• Neurology
• Geriatrics
• Epidemiology

Background:

• Functional dependency, requiring assistance with daily activities, is a crucial patient-centered outcome in Parkinson's disease (PD).
• Understanding the progression of dependency is vital for patient care and resource allocation.

Purpose of the Study:

• To describe the development of functional dependency in a community-based cohort of Parkinson's disease patients.
• To identify independent prognostic factors associated with the onset of dependency in PD.

Main Methods:

• Analysis of data from the prospective, community-based Parkinsonism Incidence in North-East Scotland (PINE) study.
• Definition of dependency using Schwab & England score (<80%) and Barthel Index (<19).
• Identification of baseline predictors using multivariable Cox regression analysis.

Main Results:

• The rate of dependency development was 14 per 100 person-years in 198 PD patients.
• Older age at diagnosis, greater smoking history, severe axial impairment, and lower Mini-Mental State Examination (MMSE) scores predicted dependency (Schwab & England).
• Older age and axial impairment severity predicted dependency (Barthel Index).

Conclusions:

• This is the first community-based study to report on dependency development in Parkinson's disease.
• A high rate of dependency development was observed.
• Older age, smoking, axial impairment, and cognitive function are independent predictors of functional dependency in PD.