Related Experiment Video
Updated: Jan 18, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Longitudinal patterns of loss of independence in Parkinson disease
Tsung-Ying Lee1, Lisa M Shulman2, Ann L Gruber-Baldini3
1Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.
Aim:
To examine the longitudinal loss of independence (LOI) in Parkinson disease (PD) and introduce event visualization as a research tool.
Methods:
Early-stage PD patients seen by a movement disorders specialist from 2003-2020 were included. LOI, defined as needing help with activities of daily living (ADLs), was assessed using the modified Older Americans Resources and Services Daily Function Questionnaire. EventFlow software visualized LOI patterns.
Results:
The cohort included 296 patients (mean age 60.8; 61% male; 94% Hoehn & Yahr stages 1-2). At baseline, 91% were independent. LOI occurred in 133 patients for ≥ 1 ADL, and in 95 patients for ≥ 3 ADLs. Housework was the most frequent first ADL needing help (58 of 133), with a mean onset of 4.6 years. Among those with LOI, 57 (43%) regained independence at least once.
Conclusion:
LOI in PD shows both transient and persistent patterns. Event visualization may aid understanding of progression and support patient counseling.
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