Visual Dysfunction and Occupational Performance in Persons With Parkinson's Disease.

IMPORTANCE: Visual function is critical to support occupational performance for persons with Parkinson's disease (PwP), yet it can be adversely affected by the disease. OBJECTIVE: To evaluate the prevalence and general awareness of visual dysfunction and identify the association between visual dysfunction and occupational performance in PwP. DESIGN: Self-reported cross-sectional electronic survey. PARTICIPANTS: PwP, identified from a registered database at a neurological institute, were invited to complete the survey through emails and newsletters. OUTCOMES AND MEASURES: The survey contained items of self-reported visual difficulties, diagnosed eye conditions, and about general awareness about disease-related visual dysfunction. Ophthalmological symptoms and occupational performance were measured with the Visual Impairment Parkinson's disease Questionnaire and the Revised Self-Reported Functional Visual Performance Scale, respectively. RESULTS: Data from PwP (n = 92; Mage = 69 yr) were analyzed. Nearly half were unaware that their disease could affect vision. Awareness was not associated with disease duration. Individuals reporting awareness tended to report difficulties with vision. Functional activities requiring vision were mildly impaired, and the frequency of ophthalmologic symptoms (commonly related to ocular surface disorder) was low. Nevertheless, a higher frequency of ophthalmologic symptoms was positively associated with a higher degree of disability in activities of daily living (Spearman's ρ = .49, p < .01). CONCLUSIONS AND RELEVANCE: Visual dysfunction related to Parkinson's disease may affect occupational performance. Screening for changes in vision in these individuals may aid occupational therapists in addressing functional independence and activity engagement. What This Article Adds: People with Parkinson's disease may not have a general awareness that the disease can adversely affect visual function. Those individuals with awareness tend to notice changes in vision, and this disease-related visual dysfunction may limit engagement and participation in everyday activities. Active evaluation of visual function in people with Parkinson's disease is recommended. Occupational therapists could play a key role by screening for visual dysfunction and providing patient education in the clinic.

Mucin degrader Akkermansia muciniphila accelerates intestinal stem cell-mediated epithelial development.

Mucin-degrading bacteria are densely populated in the intestinal epithelium; however, their interaction with intestinal stem cells (ISCs) and their progeny have not been elucidated. To determine whether mucin-degrading bacteria play a role in gut homeostasis, mice were treated with Akkermansia muciniphila, a specialized species that degrades mucin. Administration of A. muciniphila for 4 weeks accelerated the proliferation of Lgr5+ ISCs and promoted the differentiation of Paneth cells and goblet cells in the small intestine (SI). We found similar effects of A. muciniphila in the colon. The levels of acetic and propionic acids were higher in the cecal contents of A. muciniphila-treated mice than in PBS-treated mice. SI organoids treated with cecal contents obtained from A. muciniphila-treated mice were larger and could be diminished by treatment with G protein-coupled receptor (Gpr) 41/43 antagonists. Pre-treatment of mice with A. muciniphila reduced gut damage caused by radiation and methotrexate. Further, a novel isotype of the A. muciniphila strain was isolated from heathy human feces that showed enhanced function in intestinal epithelial regeneration. These findings suggest that mucin-degrading bacteria (e.g., A. muciniphila) may play a crucial role in promoting ISC-mediated epithelial development and contribute to intestinal homeostasis maintenance.