Comparison of disability level between Early and Late Onset Parkinson's Disease using WHODAS 2

Isaíra Almeida Pereira da Silva Nascimento; Kátia Cirilo Costa Nobrega; Bruno Rafael Antunes Souza; Isabela Carneiro Barone; Giovanna Checchio; Vitória Pereira Ponciano; Clara Greif Cerveira de Paula; Arieni Nunes Possani; Natália Cardoso Penha; André Frazão Helene; Antonio Carlos Roque; Rodolfo Savica; Maria Elisa Pimentel Piemonte

doi:10.3389/fneur.2023.1281537

Comparison of disability level between Early and Late Onset Parkinson's Disease using WHODAS 2

Front Neurol. 2023 Nov 15:14:1281537. doi: 10.3389/fneur.2023.1281537. eCollection 2023.

Authors

Affiliations

¹ Department of Physical Therapy, Speech Therapy, and Occupational Therapy, Faculty of Medical Science, University of São Paulo, São Paulo, Brazil.
² Department of Neuroscience and Behavior, Institute of Psychology, University of São Paulo, São Paulo, Brazil.
³ Department of Physiology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil.
⁴ Department of Physics, School of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
⁵ Department of Neurology, Mayo Clinic, Rochester, MN, United States.

^# Contributed equally.

Abstract

Background: Parkinson's disease (PD) is a degenerative neurological disorder that usually affects people over the age of 60. However, 10%-20% of patients have an early onset of PD (EOPD).

Objectives: To compare disability levels according to the World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2) between people with EOPD and those with late-onset PD (LOPD).

Methods: We conducted a cross-sectional study with 95 EOPD patients (mean-age 44.51 ± 4.63, H&Y 1.93 ± 0.93) and 255 LOPD patients (mean-age 63.01 ± 7.99, H&Y 2.02 ± 0.95). Demographic information, clinical characteristics, cognitive evaluation by Telephone-Montreal-Cognitive-Assessment (T-MoCA), functionality self-evaluation by WHODAS-2 and the Unified-Parkinson's-Disease-Rating-Scale (MDS-UPDRS), parts I and II, were documented for each patient by an individual remote interview.

Results: Analysis showed a statistically significant difference between EOPD and LOPD in two domains of WHODAS-2 only: cognition (Z-adjusted = 2.60; p-value adjusted <0.009) and activities of daily living related to work/school (Z-adjusted = 2.34; p-value adjusted <0.01). T-MoCA scores confirmed more impaired cognition capacity in LOPD (Z-adjusted = 2.42; p-value adjusted <0.01). The two groups had no significant differences in levodopa daily dosage, Hoehn and Yahr (H&Y) stages, disease time duration, and MDS-UPDRS I and II scores.

Conclusion: People living with EOPD face similar disability levels as those with LOPD, except for cognition, where LOPD patients exhibited higher levels of disability than EOPD and for work activities where the EOPD exhibited higher levels of disability than LODP. These results highlight the challenges faced by people with EOPD in interacting with society and living with the disease for a longer time. The WHODAS-2 can be a useful tool to assess disability and tailor interventions for people with PD of different age groups.

Keywords: Parkinson’s disease; WHODAS-2; cognition; disability; early onset.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001. This article was produced as part of the activities of FAPESP Research, Innovation, and Dissemination Center for Neuromathematics (grant #2013/07699-0, S. Paulo Research Foundation). AR was partially funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) grant # 303359/2022-6.