Multidimensional functional decline throughout Parkinson’s disease development
Bibliographic record
Abstract
Background: To manage diseases such as Parkinson’s Disease (PD), guide new intervention frameworks and inform patients, it is important to identify the decline in different dimensions of functionality. The functionality analyzes the complex interaction among biological, psychological, and social factors, that is why it is one of the main health indicators. The World Health Organization based on International Classification of Functioning, Disability and Health (ICF), developed the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), a generic assessment instrument to provide a method for measuring the impact of different health conditions in terms of functionality and disability across cultures. Objective: A cross-sectional study was carried out to measure how functional decline is associated with the progression of PD using WHODAS 2.0. Furthermore, a characterization of the participant functionality profile was made. Methods: There were 352 participants (55% male, 45% female), assessed with early to advanced PD (H&Y I-IV), aged between 35-85 years age, using dopaminergic medication and without other neurological disorders than PD. The instruments used were: the Telephone - Montreal Cognitive Assessment (T-MoCA), Movement Disorder Society – Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part I - II and WHODAS 2.0. Results: The descriptive analysis indicated that the most affected WHODAS 2.0 domains were domestic activities (ADL) representing 46% of the total score and subsequently mobility and participation representing 43% of the total score. The motor activities where participants found the most difficulties were: carrying out household tasks as quickly as possible (87%), getting dressed (74%), and getting up from a sitting position (71%). Furthermore, the time spent on healthcare and the emotional impact caused by the health condition also created difficulties for the participants, with 77% and 72% complaining respectively. In the Mobility, ADL, Self-Care and Participation domains, there is a significant difference between all H&Y stages confirmed by the post-hoc test. However, for the total scores of the Interpersonal Relationships, Cognition and ADLw (activities of daily living related to work and school) domains, there was no significant difference between H&Y I and II according to it. Besides that, a high positive correlation was found between WHODAS ADL with MDS-UPDRS I (R=0.53; p-value<0.00001) and MDS-UPDRS II (R=0.65; p-value<0.00001), WHODAS Self-Care and MDS-UPDRS II (R=0.82; p-value<0.00001), and between WHODAS 2.0 total scores and MDS-UPDRS I (R=0.67; p-value<0.00001) and MDS-UPDRS II (R=0.68; p-value<0.00001). A negative correlation was found between WHODAS 2.0 Cognition and T-MoCA (R=0.33; p-value<0.0001). Conclusion: Pharmacological and non pharmacological interventions should consider the clinical characterization of the different affected dimensions of functionality in people with PD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".