Objective: This study aimed to examine factors influencing the degree of improvement in the Barthel Index (BI) among hospitalized patients with PD and to clarify the interaction effect between physical and cognitive function at hospital admission.

Background: Parkinson’s disease (PD) frequently involves cognitive impairment as well as motor symptoms. While initial assessment of physical function in PD rehabilitation is considered useful for predicting outcomes, the impact of the interaction between physical and cognitive function on ADL improvement remains unclear.

Method: This study included 74 patients with PD hospitalized at St. Marianna University Hospital (age 70.2 ± 8.7 years, 43% male, Hoehn-Yahr stage 3.2 ± 0.8, disease duration 9.9 ± 5.6 years). Data were collected retrospectively from medical records. Multiple regression analysis was performed with BI improvement (discharge BI – admission BI) as the dependent variable, and admission BI, Timed Up and Go Test score (TUG), disease duration, L-dopa/day, and Trail Making Test Part B score (TMTB) reflecting attention and executive function as explanatory variables. A model including an interaction term between admission BI and TMTB was also constructed with the interaction effect examined using centering and simple slope analysis.

Results: The main effects model was significant (F = 13.23, p < 0.001, R² = 0.493), with admission BI (b = −0.432, p < 0.001) and TMTB (b = −0.070, p < 0.001) being significant explanatory variables. TUG, disease duration, and L-dopa/day were not significant. The interaction model improved explanatory power (R² = 0.542), and the interaction was significant (β = 0.257, p = 0.006). Simple slope analysis showed a greater effect of TMTB in the group with lower admission BI (b = −0.109) and nearly disappeared in the group with higher BI (b = −0.031).

Conclusion: Improvement in BI scores among patients with PD was significantly influenced by both admission BI scores and TMTB, with an interaction effect between the two factors observed. For patients with lower physical function, attention and executive function emerged as critical factors determining ADL improvement, suggesting the importance of individualized rehabilitation that comprehensively assesses both physical and cognitive function.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/interaction-between-physical-and-cognitive-function-that-determines-adl-improvement-in-hospitalized-patients-with-parkinsons-disease-implications-for-individualized-rehabilitation-strategies/