Subjective report versus objective measurement of activities of daily living in Parkinson's disease.
We compared subjective self-reports with objective performance ratings of activities of daily living (ADLs) and instrumental ADLs (IADLs) in patients with Parkinson's disease (PD) and identified variables associated with discordance of ratings between these two methods. Seventy-six PD patients completed a modified Older Americans Resources and Services scale, assessing ADLs and IADLs. These results were compared with structured performance tests of walking, eating, dressing, money, and medicine management administered in the clinic. Patient performance was rated on a five-point Likert-type scale, ranging from 1 = no difficulty to 5 = completely unable to perform task. Significant differences were found between patients and clinicians' ratings on all tasks except walking. On the other four tasks, paired group t tests showed that patients reported better function compared with the clinician rating of medication management (1.33 vs. 2.80), eating (1.53 vs. 1.76), dressing (1.64 vs. 1.86), and managing money (1.44 vs. 2.06). A discrepancy was found between patients subjective reporting of ADL and IADL function and objective ratings. Patients overestimated their function on four of five tasks. Further study is necessary to identify whether subjective or objective performance ratings are more reflective of actual daily function.
Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. lshulman@som.umaryland.edu
Lisa M
LM
Shulman
Ingrid
I
Pretzer-Aboff
Karen E
KE
Anderson
Rashida
R
Stevenson
Christopher G
CG
Vaughan
Ann L
AL
Gruber-Baldini
Stephen G
SG
Reich
William J
WJ
Weiner
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004185:Disability Evaluation; D004435:Eating; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009043:Motor Activity; D010300:Parkinson Disease / Q000503:physiopathology* / Q000523:psychology*; D015203:Reproducibility of Results; D012647:Self-Assessment; D016138:Walking
D000978:Antiparkinson Agents