Browsing by Author "Ferreira, Joaquim J."
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- Applicability study of a multitask cognitive and motor exercise program for individuals with Parkinson´s disease: The COGWEB® MOVE ProgramPublication . Domingos, Josefa; Peralta, Diana; Loureiro, Rita; Godinho, Catarina; Pais, Joana; Cruz, Vitor Tedim; Ferreira, Joaquim J."Objective: To test the applicability of a new rehabilitation program for people with Parkinson´s disease combining web-based cognitive training with motor exercises (COGWEB ® CNS Move Program)."
- Clinical diagnostic criteria have a high impact on the frequency of dementia in late-stage Parkinson's diseasePublication . Sousa, Catarina Severiano e; Fabbri, Margherita; Godinho, Catarina; Simões, Rita; Chendo, Inês; Coelho, Miguel; Martins, Isabel Pavão; Ferreira, Joaquim J.Background: Cognitive impairment is a potential late feature of Parkinson's disease (PD). However, studies in patients with late-stage PD are lacking due to the particular characteristics of this population.
- Clinical diagnostic criteria have a high impact on the frequency of dementia in late-stage Parkinson's diseasePublication . Sousa, Catarina Severiano e; Fabbri, Margherita; Godinho, Catarina; Simões, Rita; Chendo, Inês; Coelho, Miguel; Martins, Isabel Pavão; Ferreira, Joaquim J.Background: Cognitive impairment is a potential late feature of Parkinson's disease (PD). However, studies in patients with late-stage PD are lacking due to the particular characteristics of this population. Objectives: To evaluate the frequency of dementia in late-stage PD patients and to assess the impact of using different diagnostic criteria. Methods: We conducted a cross-sectional study to estimate the frequency of dementia in late-stage PD patients using the International Parkinson and Movement Disorders Society (MDS) (Level II) clinical diagnostic criteria as the primary outcome. We also applied other diagnostic criteria [MDS (Level I), DSM-IV, and DSM-5 criteria] to determine their applicability and impact on dementia frequency. Results: 93 participants with a mean age of 75.8 years (SD 6.8) and 16.5 years (SD 7.5) of disease duration were included. 64.3% were classified as demented using the International Parkinson and Movement Disorders Society (MDS) (Level II) clinical diagnostic criteria. We observed a high discrepancy on the frequency of dementia depending on the criteria applied [6.2% with MDS (Level I), 58.8% with DSM-IV, and 72.0% with DSM-5 criteria]. Conclusions: We found a frequency of dementia below what was observed in similar populations. The particular characteristics of our sample may have contributed as protective factors for late-stage dementia. Dementia frequency varied depending on the criteria used mainly due to the presence of major depression.
- Cognitive impairment in fall-related studies in Parkinson’s DiseasePublication . Domingos, Josefa M.; Godinho, Catarina; Dean, John; Coelho, Miguel; Pinto, Anabela; Bloem, Bastiaan R.; Ferreira, Joaquim J.
- Disability in activities of daily living and severity of dyskinesias determine the handicap of Parkinson´s disease patients in advanced stage selected to dbsPublication . Coelho, Miguel; Abreu, Daisy; Correia-Guedes, Leonor; Lobo, Patrícia Pita; Fabbri, Margherita; Godinho, Catarina; Domingos, Josefa; Albuquerque, Luisa; Freitas, Vanda; Pereira, João Miguel; Cattoni, Begona; Carvalho, Herculano; Reimão, Sofia; Rosa, Mário M.; Ferreira, António Gonçalves; Ferreira, Joaquim J."BACKGROUND: There is scarce data on the level of handicap in Parkinson's disease (PD) and none in advanced stage PD. OBJECTIVE: To assess the handicap in advanced stage PD patients with disabling levodopa-induced motor complications selected to deep brain stimulation (DBS). METHODS: Data was prospectively recorded during routine evaluation for DBS. Handicap was measured using London Handicap Scale (LHS) (0 = maximal handicap; 1 = no handicap). Disease severity was evaluated using the Hoehn & Yahr scale and the UPDRS/MDS-UPDRS, during off and on after a supra-maximal dose of levodopa. Schwab and England Scale (S&E) was scored in off and on. Dyskinesias were scored using the modified Abnormal Involuntary Movement Scale (mAIMS). Results concern cross-sectional assessment before DBS. RESULTS: 100 PD patients (mean age 61 (±7.6); mean disease duration 12.20 (±4.6) years) were included. Median score of motor MDS-UPDRS was 54 in off and 25 in on. Mean total LHS score was 0.56 (±0.14). Patients were handicapped in several domains with a wide range of severity. Physical Independence and Social Integration were the most affected domains. Determinants of total LHS score were MDS-UPDRS part II off (β= -0.271; p = 0.020), S&E on (β= 0.264; p = 0.005) and off (β= 0.226; p = 0.020), and mAIMS on (β= -0.183; p = 0.042) scores (R2 = 29.6%). CONCLUSIONS: We were able to use handicap to measure overall health condition in advanced stage PD. Patients were moderately to highly handicapped and this was strongly determined by disability in ADL and dyskinesias. Change in handicap may be a good patient-centred outcome to assess efficiency of DBS."
- Dysphagia predicts poor outcome in late-stage Parkinson's diseasePublication . Fabbri, Margherita; Coelho, Miguel; Abreu, Daisy; Guedes, Leonor Correia; Rosa, Mario M.; Godinho, Catarina; Cardoso, Rita; Guimarães, Isabel; Antonini, Angelo; Zibetti, Maurizio; Lopiano, Leonardo; Ferreira, Joaquim J."BACKGROUND: Few data exist on the rate of clinical progression for Parkinson's disease (PD) patients who have entered a late stage of the disease. OBJECTIVE: Study the clinical progression of a late-stage PD (LSPD) population over one year follow-up. METHODS: 50 LSPD patients (Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 in MED ON) underwent an extensive clinical assessment at baseline and after one year and an acute levodopa test at baseline. RESULTS: Mean age of LSPD patients (female 46%) was 77.5 ± 5.9 years and mean disease duration was 15.5 ± 6.5 years. At baseline, 76% had levodopa-induced motor complications (MC), usually non-troublesome, 68% were demented, 54% had psychosis and 68% depression. Caregiver distress was high. l-dopa responsiveness was mild (18% ± 12 of improvement on MDS-UPDRS-III). After one-year, 20% of the patients were dead, institutionalized or HY 5. MDS-UPDRS-motor mean score worsened 7.2 ± 10.3 points although there was heterogeneity between patients, and there was a global worsening of non-motor symptoms, mostly in cognition/mood, urinary and gastrointestinal domains. Nevertheless, MC improved despite similar levodopa equivalent dose. Functional independence and quality of life worsened. Dysphagia severity at baseline predicted a poor outcome (death, institutionalization or HY 5) (Hazard ratio 2.3, 95% CI 1.12-4.4; p = 0.01), whereas magnitude of l-dopa response of LSPD patients did not. CONCLUSIONS: LSPD patients still present a significant, although heterogeneous, motor and non-motor progression over 1 year. Dysphagia severity predicts the occurrence of additional disease severity milestones and its management must be prioritized."
- Feasibility study of an intensive multi-strategy rehabilitation program for Parkinson diseasePublication . Domingos, Josefa M.; Caniça, Veronica; Godinho, Catarina; Pinho, Alice; Guerreiro, Daniela; Ferreira, Joaquim J.
- Frequência da desnutrição em idosos institucionalizados com doenças neurológicasPublication . Gomes, Rita; Miranda, Diana; Pereira, Paula; Godinho, Catarina; Ferreira, Joaquim J.
- Frequency of falls in nursing homes for neurodegenerative diseasesPublication . Godinho, Catarina; Domingos, Josefa; Pereira, Ana; Duarte, Márcia; Ferreira, Joaquim J."Objective: This study aimed to: 1) identify the frequency and characteristics (causes, circumstances, consequences, treatments), of falls that occurred at Campus Neurológico Senior (CNS) from October 2013 until June 2015; and 2) define preventive strategies and interventions tailored to the specific causes of the falls identified."
- Frequency of falls in nursing homes for neurodegenerative diseasesPublication . Godinho, Catarina; Domingos, Josefa; Pereira, Ana; Duarte, Márcia; Ferreira, Joaquim J.