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Influence of Educational Status on Executive Function and Functional Balance in Individuals with Parkinson Disease

Souza, Carolina de Oliveira MSc*; Voos, Mariana Callil PhD*,†; Francato, Débora Valente BS*; Chien, Hsin Fen PhD*; Barbosa, Egberto Reis PhD*

Cognitive and Behavioral Neurology: March 2013 - Volume 26 - Issue 1 - p 6–13
doi: 10.1097/WNN.0b013e31828c5956
Original Studies

Objective: This study investigated whether educational status influenced how people with Parkinson disease (PD) performed on Parts A, B, and DELTA of the Trail Making Test (TMT) and on the Berg Balance Scale (BBS).

Background: Recent studies have shown that educational status may influence cognitive and motor test performance.

Methods: We gave the TMT and the BBS to assess executive function and functional balance in 28 people with PD (Hoehn and Yahr score between 2 and 3) and 30 healthy elderly people. Participants reported their number of years of formal education. We divided each group of participants by educational status: low (4 to 10 years of education) or high (≥11 years).

Results: In both the PD (P=0.018) and control (P=0.003) groups, participants with low educational status performed worse on the TMT Part B than did those with high educational status. Within the PD group, the less-educated participants scored worse on the BBS than did the more educated (P<0.001); this difference was not significant between the more- and less-educated controls (P=0.976).

Conclusions: Whether or not they had PD, less-educated people performed worse than more-educated people on the TMT Part B. Educational status affected executive function, but PD status did not. Among individuals with PD, educational status influenced functional balance.

*Movement Disorders Clinic, Department of Neurology, Hospital das Clínicas

Physical Therapy, Occupational Therapy and Speech Therapy Department, University of São Paulo School of Medicine, São Paulo, Brazil

C.deO.S. received a grant from the Movement Disorder Society to attend the 2011 Movement Disorder Society International Congress and present the abstract of this work as a poster.

The authors declare no conflicts of interest.

Reprints: Carolina de Oliveira Souza, MSc, Rua Sergipe, 401, cj 1101. CEP 01243-001, Higienópolis, São Paulo, SP, Brazil (e-mail:

Received February 21, 2012

Accepted October 30, 2012

© 2013 Lippincott Williams & Wilkins, Inc.