Disability

Parkinson’s disease (PD), a chronic, progressive neurodegenerative disorder

of unknown etiology, affects approximately 1% of the population over age

50 and up to 2.5% of the population over age 70. United States government

figures from 1994 estimate annual societal costs related to PD at $20 billion

dollars,1 and much of this appears related to higher hospitalization rates and

longer length of stay2 with accompanying disability driving much of the

healthcare utilization among these patients.3 Community studies have found

that PD patients have greater physical, social, and emotional disability than

that experienced by individuals with other chronic conditions such as dia-

betes mellitus.4 While the societal burden is measured in dollars, the impact

on patients and by extension their families, requires additional metrics. This

chapter will present information on the disabilities that often accompany

Parkinson’s disease, including definitions of key concepts in the disability

field, examples of the major areas of disability, means of assessment, a dis-

cussion of factors that influence both the presentation and extent of these

disabilities and finally suggestions for intervention and management.