Dados do Trabalho

Título

Association between balance performance and cognitive impairment in people with Parkinson's disease

Resumo

Introduction: People with Parkinson's Disease (PD) often use cognitive strategies to maintain balance and postural stability due to their deficits in terms of automaticity, among the motor symptoms presented in the disease, postural instability is one of the most disabling and seems to be related to cognitive deficits. Aim: In this study, we determined the cognitive factors that may be related to balance deficits in individuals with PD. Methods: A sample of 74 participants, recruited in a Parkinson's association in São Paulo, being 22 healthy elderly (CG) and 52 people with Parkinson's, subdivided into early (IPG) and moderate (MPG) Parkinson's was evaluated based on variables clinical and social, among the variables evaluated, the groups were homogeneous in terms of age (p=0.14), education (p=0.21). The groups were different in terms of motor presentation measured from the MDS-Unified Parkinson's Disease Rating Scale Part II and III. For balance evaluation, the Balance Evaluation Systems Test (BESTest) was used in its complete format, evaluating domains such as Biomechanics, Stability Limits, Postural Responses, Anticipatory Postural Adjustments, Sensory Orientation and Dynamic Balance during gait and cognitive effects and for the cognitive impairment, the Montreal Cognitive Assessment (MoCA), a brief screening instrument for mild cognitive impairment. It accesses different cognitive domains: attention and concentration, executive functions, memory, language, visual-constructive skills, conceptualization, calculation and orientation. This study was approved by a Local Ethics Committee (CAAE 67388816.2.0000.0065). Results: MoCA data, especially when comparing the MPG group with the others, were different due to the presence of some cognitive deficit with the progression of the disease (p=0.031). A positive correlation was demonstrated between the total values of MoCA and the Best TEST (p<0.009; r=.3047), as in specific domains related to visuospatial memory and visuospatial orientation (p<0.001; r=.3786), evaluated respectively. Conclusion and discussion: Visuospatial memory is important in everyday activities that require location of the individual in space, differentiation of shape and spatial location of objects. Previous studies indicate that visuospatial memory is related to gait rhythm and postural control in healthy elderly people and those with PD. Thus, deficits in visuospatial memory are related to a higher risk of falls in this group of people.