A patient with Parkinson's disease reports difficulty with home care. Which aspect of self-care is MOST likely to be compromised?

Correct answer: C. Toothbrushing and flossing

• A. Rinsing is a gross motor task and is comparatively preserved, though swallowing difficulty should be considered in advanced disease.
• B. Attendance may be affected by mobility and transport, but the direct self-care deficit tested here is manual dexterity.
• C. Correct. Parkinson's disease produces resting tremor, bradykinesia, rigidity and loss of fine motor dexterity. The tasks that demand the most precise manual control — manipulating a toothbrush at the gingival margin and threading floss — are the first to fail. Recommend a powered toothbrush with a wide handle, floss holders/interdental brushes, and caregiver assistance.
• D. Cognition is often preserved in early and mid-stage Parkinson's; the limitation is motor execution, not comprehension.