Date Presented 03/28/20
Individuals with PD often experience cognitive deficits that can cause functional limitations and reduced quality of life. Cognitive self-efficacy (CSE), the belief in one’s own cognitive capacities, may impact how a person with PD performs and participates in cognitively challenging occupations or responds to cognitive interventions. Investigating CSE among individuals with PD would be important to effectively address functional cognitive performance and improve quality of life.
Primary Author and Speaker: Pooja Jethani
Additional Authors and Speakers: Erin Foster
Contributing Authors: Joan Toglia
PURPOSE: Parkinson’s disease (PD) is associated with cognitive deficits that negatively impact function and quality of life. It is currently unclear how the onset and progression of PD affects people’s perceptions of their cognitive capacities, including their cognitive self-efficacy. Cognitive self-efficacy (CSE) is the belief in one’s own capacity to cope with cognitively challenging activities and to use cognitive skills effectively in various situations. It contributes to self-regulation, goal-setting, motivation, and use of self-management strategies. Individuals with lower CSE may unreasonably avoid tasks that require cognitive effort, resulting in increased dependency, unemployment, social isolation, depression, and decreased quality of life. The purpose of this study was to assess CSE in individuals with PD and age matched healthy adults, thereby, determining the effect of PD on CSE, including the potential influence of demographic and disease-related characteristics on CSE among individuals with PD.
DESIGN: The study was a cross sectional observational study. Participants were volunteers aged 50-75 with PD without dementia (n=47) recruited from a university Movement Disorders Center and age-matched healthy older adults (n=52) recruited from the community.
METHOD: The Cognitive Self-Efficacy Questionnaire (CSEQ)1 was used to assess participants’ beliefs regarding their ability to recognize (Part 1) and manage (Part 2) cognitive symptoms and to perform cognitively complex functional activities (Part 4); higher scores indicate better CSE in these areas. Mixed ANOVA compared CSEQ scores for each part within and across participant groups, and Pearson r assessed the relationships between CSEQ scores and demographic and disease-related characteristics (e.g., age, education, motor dysfunction severity, depressive symptoms) within the PD group.
RESULTS: There was a main effect of group indicating that the PD group reported lower CSE scores than the control group, F(1,83) = 12.79, p = 0.001. There was a main effect of CSEQ Parts such that the scores to recognize(Part 1) and perform complex cognitive functional activities(Part 4) were higher than the scores to manage cognitive tasks (Part 2), F(2,166) = 4.24, p = 0.016. This main effect was qualified by an interaction, such that the differences between the CSEQ Parts were only significant for the PD group, F(2,166) = 4.06; p = 0.019. Within PD, there was a negative correlation between depressive symptoms and each of the CSEQ Parts (r<-0.304; p<0.04) and between total dopaminergic medication dosage and CSEQ Part 4 (r=-0.441; p=0.003). There were no other correlations between demographic and disease-related characteristics (e.g., disease stage, disease duration, motor dysfunction, education, age) and the CSEQ (p > 0.53).
CONCLUSION: These results indicate that individuals with PD have reduced CSE compared to their healthy peers. Furthermore, self-efficacy to manage cognitive symptoms is particularly low in people with PD. In addition, factors such as increased depressive symptoms and higher medication dosage (which may be an indicator of disease severity) may contribute to poor CSE among people with PD. These findings can impact occupational therapy for people with PD by calling attention to CSE so that treatment can involve strategies to monitor, analyze and regulate CSE. Better analysis of their CSE would ultimately increase PD clients’ engagement in the intervention process and cognitively challenging tasks, thereby improving their daily function and quality of life.
References
1. Toglia, J., Johnston, VM., (2017). Cognitive self efficacy questionnaire II. Retrieved from https://static1.squarespace.com/static/596d1d73e58c62ed965e22d5/t/5a0361104192022ab5246e3c/1510170898173/Toglia_CSEQRevised.pdf
2. Bandura A. (1993) Perceived Self-Efficacy in Cognitive Development and Functioning. Educational Psychologist, 28(2), 1 17-148
3. Muslimovic D1, Post B, Speelman JD, Schmand B. (2005) Cognitive profile of patients with newly diagnosed Parkinson disease.:Neurology. 2005 Oct 25;65(8):1239-45. DOI: 10.1212/01.wnl.0000180516.69442.95
