Objective: To explore the relationship between health literacy and cognitive impairment in PwPD
Background: Parkinson’s disease (PD) is a complex neurodegenerative disorder with cognitive, psychiatric and motor impact. Treatment choice to optimize care and outcomes in people with PD (PwPD) often reflects a shared decision making process. Adequate Health Literacy (HL), (the ability to understand and make informed decisions about a health condition), is important to optimize this process. Cognitive impairment (CI) might impact this process. Cognitive impairment (CI) in PwPD can vary in degree and combination of cognitive domain impairment. Clinician under appreciation of CI in PwPD might be problematic. Optimizing recognition of CI and appreciating the degree of HL for clinicians treated PwPD might enhance decision making and outcomes.
Method: Retrospective review of data collected through routine care in PwPD that were evaluated by a multidomain computerized cognitive testing battery (CAB, NeuroTrax) and completed the following Patient Reported Outcomes (PRO): BRIEF Health Literacy (HL), Self-efficacy for Managing Medications and Treatments, (MM), and Lawton-Brody Instrumental Activities of Daily Living (IADL). CAB Cognitive domains assessed: Memory (MEM), Executive Function (EF), Visual Spatial (VS), Information Processing (IP), Verbal Function (VF), Attention (ATT), and a Global Cognitive Summary Score (GCS)
Results: 92 PwPD 64% male, average age 73+/-9. Inadequate HL was identified in 41.3% of PwPD, 26.1% had marginal HL and 32.6% had adequate HL. 49.1% of males had inadequate HL, while only 27.2% of females had inadequate health literacy. Significant relationships identified by regression analysis (p<.05): HL vs GCS (r2=0.36), HL vs MEM (r2=0.25), HL vs EF (r2=0.22), HL vs VS (r2=0.16), HL vs IP (r2=0.26), HL vs VF (r2=0.17), HL vs ATT (r2=0.20), HL vs MM (r2= 0.68), and HL vs IADL (r2=0.41).
Conclusion: Inadequate HL is common in PwPD. Cognitive impairment in PwPD impacts HL. Patients who reported lower HL also reported lower MM and IADL scores. CAB provides added value to care of PwPD to recognize disease burden that directly impacts treatment decisions. Proactive recognition of important and relevant disease burden might enhance treatment decisions, improving adherence, outcomes and unanticipated healthcare costs.
To cite this abstract in AMA style:
O. Kaczmarek, A. Sethi, P. Tierney, B. Bumstead, M. Buhse, E. Kravis, B. Anand, M. Zarif, M. Gudesblatt. Parkinson’s Disease, Cognitive Function and Health Literacy: A Problem with Shared Decision Making [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/parkinsons-disease-cognitive-function-and-health-literacy-a-problem-with-shared-decision-making/. Accessed December 9, 2023.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-cognitive-function-and-health-literacy-a-problem-with-shared-decision-making/