Objective: To investigate the decline in functionality according to WHODAS-2.0 from early to intermediate stages of PD.

Background: Parkinson’s disease (PD) is an incurable and chronic condition that causes both motor and non-motor alterations. These alterations progressively increase the level of disability and decrease the functionality of the affected individual. To provide a standardized method for measuring the impact of any health condition in terms of functionality, the WHO has developed the Disability Assessment Schedule (WHODAS-2.0), based on the ICF-framework.

Method: This cross-sectional study was included 350 individuals with idiopathic PD (189 women and 161 men) with a mean age of 58.10 ±11.04 years, between stages I-III in the H&Y scale. The mean time since diagnosis was 7.09 years (±5.53) . The data collection were involved the application of the functionality questionnaire (WHOODAS-2.0), the assessment of motor and non-motor alterations (MDS-UPDRS I and II) and clinical characterization data. All the tests were completed remotely by a specialized physiotherapist in a single call by telephone. We used a six Kruskal-Wallis ANOVA, one for each WHODAS-2.0 domains, to compare the H&Y-stages (I-II-III). Additionally, we used the Pearson test to test the correlation between WHODAS-2.0 total scores and MDS-UPDRS I and II.

Results: The KW-ANOVA analysis, adjusted for multiple comparisons, revealed that the H&Y stages had a significant effect on both the total score and all domains of the WHODAS 2.0. In pair-to-pair comparisons, statistically significant differences (p<.001) were observed between all three H&Y stages for the total score and most WHODAS-2.0 domains. However, for the Cognition and Activities related to the job domains, there was a significant difference only between stage I and III H&Y (p<.01). Additionally, there was a statistically significant correlation between the total scores of WHODAS 2.0 with UPDRS I (r=0.67) and UPDRS II (r=0.66).

Conclusion: As PD progresses, all aspects of functionality gradually decline since the early stages of the disease. However, only cognition and work activities are impaired at a later stage. To minimize the decline in functionality, comprehensive care should be provided by an interprofessional team from the time of PD diagnosis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/decline-in-functionality-according-to-whodas-2-0-associated-with-disease-progression-in-people-with-parkinsons-disease/