Activities of daily living in Parkinson's disease: Time/gender perspective.

OBJECTIVE: The objectives of this study were to explore the changes in the activities of daily living (ADL) in persons with Parkinson's disease (pwPD) over time and to investigate possible differences in ADL performance between men and women with PD. MATERIALS & METHODS: One hundred twenty-nine persons (76 men) with a clinically established PD self-assessed their ADL performance from the time of diagnosis up to 8 years follow-up using the ADL taxonomy. Other demographic and clinical data (motor state, cognition, depression) were also collected and subjected to further analysis. RESULTS: Nine of 12 domains in the ADL taxonomy showed a change over time (Eating and Drinking [P = .009], Mobility [P < .001], Toilet activities [P = .031], Dressing [P < .001], Personal hygiene [P < .001], Communication [P < .001], Cooking [P = .001], Shopping [P < .001] and Cleaning [P < .001]). In addition to time, two domains, (Shopping [P = .007] and Cleaning [P = .027]) also showed an effect of gender with worse scores in women. The nine ADL domains showing effect of time, showed temporary improvement at 12 months follow-up, most probably due to dopaminergic medication. All nine domains deteriorated at later follow-up. CONCLUSIONS: As expected, there was deterioration in self-assessed performance in the majority od ADL domains over time. Women assessed their ADLs worse in two domains (Shopping and Cleaning) probably reflecting a general gender-related activity pattern rather than being a PD-specific finding.

Are Patients Ready for "EARLYSTIM"? Attitudes towards Deep Brain Stimulation among Female and Male Patients with Moderately Advanced Parkinson's Disease.

Objective. To explore, in female and male patients with medically treated, moderately advanced Parkinson's disease (PD), their knowledge and reasoning about Deep Brain Stimulation (DBS). Methods. 23 patients with PD (10 women), aged 46-70, were interviewed at a mean of 8 years after diagnosis, with open-ended questions concerning their reflections and considerations about DBS. The interviews were transcribed verbatim and analysed according to the difference and similarity technique in Grounded Theory. Results. From the patients' narratives, the core category "Processing DBS: balancing symptoms, fears and hopes" was established. The patients were knowledgeable about DBS and expressed cautious and well considered attitudes towards its outcome but did not consider themselves ill enough to undergo DBS. They were aware of its potential side-effects. They considered DBS as the last option when oral medication is no longer sufficient. There was no difference between men and women in their reasoning and attitudes towards DBS. Conclusion. This study suggests that knowledge about the pros and cons of DBS exists among PD patients and that they have a cautious attitude towards DBS. Our patients did not seem to endorse an earlier implementation of DBS, and they considered that it should be the last resort when really needed.

Gender differences in quality of schoolwork task performance among typically developing students and students at risk of or with mild disabilities.

AIM: As no studies have examined for gender differences in quality of schoolwork task performance, the purpose of this study was to examine whether there is a gender difference in quality of schoolwork task performance among students at risk of or with mild disabilities, and to compare any identified differences to those that might exist among their typically developing peers. METHODS: The participants were 2510 students (typically developing = 412 girls, 422 boys; at risk = 147 girls, 379 boys; mild = 242 girls, 901 boys), 4-10 years of age. Schoolwork task performance was measured using the School Version of the Assessment of Motor and Process Skills (School AMPS). RESULTS: Regression analyses revealed no significant gender or age-by-gender interaction effects for any of the three groups (typically developing, at risk, mild). INTERPRETATION: The results, focused on occupational performance, complement prior research that has focused on examining for gender differences in behaviour, academic achievement, and coordination among students with mild disabilities. These results also suggest that current School AMPS normative values, based on combined gender means, are valid.