Everyday life consequences of Parkinson's disease: Community participation and integration

Objective: Besides describing deficits and clinical symptoms in Parkinson’s disease there is a level of analysis at which the target is to describe the type and degree of disabilities which may limit and interfere with everyday life expression and participation of these persons. The aim of the study is to assess everyday life effects of clinical symptoms on community participation and participation of persons with Parkinson’s disease with different levels of cognitive efficiency. Method: Forty-four patients with a diagnosis of Parkinson disease were included in the study. UPDRS was used to assess the severity of clinical symptoms. Cognitive efficiency was assessed using FAB (Frontal Assessment Battery) score and (Mini Mental State Examination). A full neuropsychological assessment was also conducted. Patients were then grouped as normal, mild and moderate. Basic and functional activities of everyday life (ADL and IADL) and BIA (Basic Interaction Abilities) were also evaluated. Quality of Life was assessed using PDQ scale. Community Integration Questionnaire was administered. It is a self report inventory which measures home participation, social integration and work productivity. It yields separate scores for each of the three sub-scales and an overall score. Results: Social participation and integration, either familial, social and productive, are reduced in PD patients and decrease according to cognitive efficiency and clinical symptoms severity, although specific components show a different line of progression. Length of disease seems to affect only social integration; while ADL and IADL, together with BIA, seem to affect all components measured. Conclusion: The study shows that also in the early stages of the disease, in patients with mild symptoms and/or preserved cognitive efficiency, the disease may interfere with quality of life and well being, as indexed by social participation and integration. This issue should be systematically addressed both during assessment and in rehabilitation planning.