Neuropsychiatric predictors of disability and functional dependence in older adults with Parkinson’s disease and related movement disorders: a population-based study in Chile
Valentina Luksic Cataldo, Franklin Vidal HerreraABSTRACT
Purpose
To analyse the association between neuropsychiatric symptoms and severity of disability and functional dependence in older adults with Parkinson’s disease in Chile.
Methods
A cross-sectional secondary analysis of the National Disability and Dependency Survey (ENDIDE 2022) was conducted, which included 135 older adults (mean age 77.7 ± 8.6 years) with Parkinson’s disease or related movement disorders. Disability and functional dependence were modelled as ordinal variables (mild, moderate and severe). Neuropsychiatric variables, including cognitive impairment/dementia, depressive symptoms, anxiety and sleep–wake disorders, were derived from self-reported conditions during the survey. Multivariable ordinal logistic regression models adjusted for age, sex and comorbidities were used to evaluate associations with functional outcomes. Clinical staging measures were not available in the dataset.
Results
Cognitive impairment showed elevated odds for disability (aOR 8.28; 95% CI = 1.42–159.83) and was associated with functional dependence severity (aOR 4.19; 95% CI = 1.34–15.26). Depressive symptoms were associated with greater disability severity (aOR 3.09; 95% CI = 1.08–9.88), but did not remain significant for functional dependence after adjustment. In addition, balance problems, unintentional weight loss and difficulties in medication management were associated with worse functional outcomes.
Conclusions
Neuropsychiatric symptoms, particularly cognitive impairment and depressive symptoms, were associated with disability and functional dependence severity in older adults with Parkinson’s disease. Cognitive impairment appeared to show a stronger association with functional dependence, whereas depressive symptoms were more closely related to disability severity. These findings suggest the value of multidisciplinary rehabilitation approaches integrating cognitive and mental health support to preserve functional autonomy.