title: Instrumental activities of daily living are impaired in Parkinson's disease patients with mild cognitive impairment.
abstract: OBJECTIVE
  Although it is well known that Parkinson's disease (PD) with dementia results in functional decline, little is known about the impact of mild cognitive impairment in PD (PD-MCI) on day-to-day functioning.
  
  
  METHODS
  Forty-one individuals with PD-MCI, 56 PD patients with normal cognition (PD-NC), and 47 healthy older adults were administered two performance-based measures of instrumental activities of daily living (IADLs) that evaluated medication and financial management. Informants of the PD patients were also administered an IADL questionnaire.
  
  
  RESULTS
  There were no significant differences between PD-NC and healthy older adults on the performance-based measures of medication and financial management. However, PD-MCI patients demonstrated significantly lower scores on the performance-based measures of medication and financial management compared with healthy older adults. PD-MCI patients were also impaired compared with PD-NC patients on performance-based medication management, but no difference between these groups was observed for ability to manage finances. Performance-based financial and medication management did not correlate with scores on neuropsychological measures in PD-MCI patients. PD-MCI and PD-NC patients showed comparable scores on the informant-based IADL questionnaire.
  
  
  CONCLUSIONS
  Performance-based measures of IADLs, particularly medication management ability, are sensitive to subtle functional declines in PD-MCI. Although impairment in performance-based measures is associated with cognitive status in PD, IADLs may be a separate domain of functioning from cognitive functioning in PD-MCI as these measures did not correlate with performance on the neuropsychological measures. Overall, performance-based assessment of IADLs may add to the clinical evaluation of PD-MCI.
authors.affiliation: Veterans Affairs, San Diego Health Care System.
authors.forename: Eva
authors.initials: E
authors.lastname: Pirogovsky
authors.affiliation: Veterans Affairs, San Diego Health Care System.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Schiehser
authors.affiliation: Veterans Affairs, San Diego Health Care System.
authors.forename: Kristalyn M
authors.initials: KM
authors.lastname: Obtera
authors.affiliation: Veterans Affairs, San Diego Health Care System.
authors.forename: Mathes M
authors.initials: MM
authors.lastname: Burke
authors.affiliation: Veterans Affairs, San Diego Health Care System.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Lessig
authors.affiliation: Veterans Affairs, San Diego Health Care System.
authors.forename: David D
authors.initials: DD
authors.lastname: Song
authors.affiliation: Veterans Affairs, San Diego Health Care System.
authors.forename: Irene
authors.initials: I
authors.lastname: Litvan
authors.affiliation: Veterans Affairs, San Diego Health Care System.
authors.forename: J Vincent
authors.initials: JV
authors.lastname: Filoteo
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D060825:Cognitive Dysfunction / Q000150:complications*; D005260:Female; D005376:Financial Management; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000523:psychology*