1. Predictors of Loss of Functional Independence in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up and Comparison with a Control Group
- Author
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García, Diego Santos, Fonticoba, Teresa de Deus, Bartolomé, Carlos Cores, Ríos, Lucía Naya, Roca, Lucía García, Miró, Cristina Martínez, Canfield, Hector, Jesús, Silvia, Aguilar, Miquel, Pastor, Pau, Cosgaya, Marina, Caldentey, Juan García, Caballol, Nuria, Legarda, Inés, Vara, Jorge Hernández, Cabo, Iria, Manzanares, Lydia López, Aramburu, Isabel González, Rivera, María A. Ávila, Mayordomo, Víctor Gómez, Nogueira, Víctor, Puente, Víctor, Dotor, Julio, Borrué, Carmen, Vila, Berta Solano, Sauco, María Álvarez, Vela, Lydia, Escalante, Sonia, Cubo, Esther, Padilla, Francisco Carrillo, Castrillo, Juan C. Martínez, Alonso, Pilar Sánchez, Losada, Maria G. Alonso, Ariztegui, Nuria López, Gastón, Itziar, Kulisevsky, Jaime, Estrada, Marta Blázquez, Seijo, Manuel, Martínez, Javier Rúiz, Valero, Caridad, Kurtis, Mónica, Fábregues, Oriol de, Ardura, Jessica González, Redondo, Ruben Alonso, Ordás, Carlos, Díaz, Luis M. López, McAfee, Darrian, Martinez-Martin, Pablo, Mir, Pablo, Group, COPPADIS Study Group COPPADIS Study, Institut Català de la Salut, [Santos García D, Cores Bartolomé C, Naya Ríos L, García Roca L, Martínez Miró C] CHUAC, Complejo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain. [de Deus Fonticoba T] 2 CHUF, Complejo Hospitalario Universitario de Ferrol, 15405 A Coruña, Spain. [Hernández Vara J, de Fábregues O] Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, and Curemos el Párkinson
- Subjects
Medicine (General) ,medicine.medical_specialty ,Discapacitats ,Parkinson's disease ,Activities of daily living ,Parkinson, Malaltia de - Complicacions ,Parkinson, Malaltia de - Prognosi ,Clinical Biochemistry ,Dependency ,Disease ,gait ,Article ,Hosmer–Lemeshow test ,Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores] ,R5-920 ,enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::enfermedades de los ganglios basales::trastornos parkinsonianos::enfermedad de Parkinson [ENFERMEDADES] ,Internal medicine ,Medicine ,Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Disease Progression [DISEASES] ,Gait ,Disability ,business.industry ,medicine.disease ,Control subjects ,afecciones patológicas, signos y síntomas::procesos patológicos::atributos de la enfermedad::progresión de la enfermedad [ENFERMEDADES] ,disability ,enfermedades del sistema nervioso::manifestaciones neurológicas::trastornos neurológicos de la marcha [ENFERMEDADES] ,Cohort ,Parkinson’s disease ,Functional independence ,Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Basal Ganglia Diseases::Parkinsonian Disorders::Parkinson Disease [DISEASES] ,activities of daily living ,business ,dependency ,Nervous System Diseases::Neurologic Manifestations::Gait Disorders, Neurologic [DISEASES] ,Other subheadings::Other subheadings::/complications [Other subheadings] - Abstract
Background and objective: The aim of this study was to compare the progression of independence in activities of daily living (ADL) in Parkinson’s disease (PD) patients versus a control group, as well as to identify predictors of disability progression and functional dependency (FD). Patients and Methods: PD patients and control subjects, who were recruited from 35 centers of Spain from the COPPADIS cohort between January 2016 and November 2017 (V0), were included. Patients and subjects were then evaluated again at the 2-year follow-up (V2). Disability was assessed with the Schwab &, England Activities of Daily Living Scale (S&, E-ADLS) at V0 and V2. FD was defined as an S&, E-ADLS score less than 80%. Results: In the PD group, a significant decrease in the S&, E-ADLS score from V0 to V2 (N = 507, from 88.58 ± 10.19 to 84.26 ± 13.38, p <, 0.0001, Cohen’s effect size = −0.519) was observed but not in controls (N = 124, from 98.87 ± 6.52 to 99.52 ± 2.15, p = 0.238). When only patients considered functional independent at baseline were included, 55 out of 463 (11.9%) converted to functional dependent at V2. To be a female (OR = 2.908, p = 0.009), have longer disease duration (OR = 1.152, p = 0.002), have a non-tremoric motor phenotype at baseline (OR = 3.574, p = 0.004), have a higher score at baseline in FOGQ (OR = 1.244, 0.0001) and BDI-II (OR = 1.080, p = 0.008), have a lower score at baseline in PD-CRS (OR = 0.963, p = 0.008), and have a greater increase in the score from V0 to V2 in UPDRS-IV (OR = 1.168, p = 0.0.29), FOGQ (OR = 1.348, 0.0001) and VAFS-Mental (OR = 1.177, p = 0.013) (adjusted R-squared 0.52, Hosmer and Lemeshow test = 0.94) were all found to be independent predictors of FD at V2. Conclusions: In conclusion, autonomy for ADL worsens in PD patients compared to controls. Cognitive impairment, gait problems, fatigue, depressive symptoms, more advanced disease, and a non-tremor phenotype are independent predictors of FD in the short-term.
- Published
- 2021