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da Costa Pereira JP, Queiroz Júnior JRAD, Medeiros LCD, Araújo Bezerra GK, Porto IVP, Cabral PC, Luz MCLD, Pinho CPS, Romero RA. Sarcopenia and dynapenia is correlated to worse quality of life perception in middle-aged and older adults with Parkinson's disease. Nutr Neurosci 2024; 27:310-318. [PMID: 36932322 DOI: 10.1080/1028415x.2023.2190246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
BACKGROUND There are few studies that assess the relationship between nutritional status and quality of life in individuals with Parkinson's disease, despite the well-established negative impact of sarcopenia and dynapenia on functional capacity and quality of life. These conditions impair protein-muscular status and are prevalent in individuals with Parkinson's disease. This study aimed to examine the relationship between nutritional status, including body composition, functional capacity, and diagnosis of sarcopenia and dynapenia, and quality-of-life perception in individuals with Parkinson's disease. METHODS This is a cross-sectional study conducted in two Parkinson's disease centers in the northeast of Brazil. The researchers assessed muscle strength, muscle mass, and physical performance to diagnose dynapenia, sarcopenia and functional capacity. Quality of life was estimated using the Parkinson's disease Quality of Life Questionnaire. RESULTS We found positive correlations between quality of life and variables such as severity and duration of the disease, as well as positive screening for sarcopenia (p<0.001). Negative correlations were observed between quality of life and muscle strength and functional capacity. The study also found that individuals with sarcopenia and dynapenia had significantly worse quality-of-life scores compared to those who did not have these nutritional outcomes (p <0.05; p <0.001). CONCLUSIONS The presence of sarcopenia, dynapenia, low gait speed, disease duration, and severity had an impact on higher scores in the Parkinson's Disease Quality of Life Questionnaire, indicating a worsening perception of quality of life.
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Affiliation(s)
- Jarson Pedro da Costa Pereira
- Hospital das Clínicas of Pernambuco, Recife, Brazil
- Department of Nutrition, Federal University of Pernambuco, Recife, Brazil
| | | | | | | | | | | | - Marcella Campos Lima da Luz
- Hospital das Clínicas of Pernambuco, Recife, Brazil
- Department of Nutrition, Federal University of Pernambuco, Recife, Brazil
| | - Cláudia Porto Sabino Pinho
- Hospital das Clínicas of Pernambuco, Recife, Brazil
- Department of Nutrition, Federal University of Pernambuco, Recife, Brazil
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Pereira JPDC, Gomes ACB, Queiroz Júnior JRAD, Nascimento TGD, Luz MCLD, Albuquerque MNDL, Cabral PC. Dynapenic abdominal obesity is related to cardiovascular risk in older adults with Parkinson's disease: A cross sectional study. Clin Nutr ESPEN 2023; 54:288-292. [PMID: 36963875 DOI: 10.1016/j.clnesp.2023.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND AND AIMS Currently, the impact of nutritional status in Parkinson's disease over the cardiovascular risk is poorly understood. Thus, this study aimed to evaluate dynapenic abdominal obesity and its influence in anthropometric parameters of cardiovascular risk in older patients with Parkinson's disease. METHODS This is a cross-sectional study involving outpatients diagnosed with Parkinson's disease in two treatment centers in northeast of Brazil. We included patients who aged 60 years and older. The data was collected from January to July of 2019. For abdominal obesity, waist circumference was used. For dynapenia, Handgrip Strength was measured. Dynapenic abdominal obesity was established as the coexistence of dynapenia and abdominal obesity. RESULTS The dynapenic abdominal obesity occurred in 25% of the patients and was higher in women (p = 0.073). The dynapenic abdominal obesity group had a decreased muscle strength, higher values of Body Mass Index, a worse Waist Height Ratio; increased values of Fat Mass and percentual of Fat Mass and an increased value of Conicity Index (p < 0,05). CONCLUSION The occurrence of dynapenic abdominal obesity in our population was related to the worsening of anthropometric values of cardiovascular risk. From our results we can suggest that the early identification of the coexistence of nutritional disorders, such as dynapenia and abdominal obesity can help in the appropriate intervention to mitigate the risks related to adverse events.
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Affiliation(s)
- Jarson Pedro da Costa Pereira
- Federal University of Pernambuco, Prof. Moraes Rego Avenue, 1235 - Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil.
| | - Andressa Caroline Burgos Gomes
- Federal University of Pernambuco, Prof. Moraes Rego Avenue, 1235 - Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil
| | | | - Taís Galdêncio do Nascimento
- Federal University of Pernambuco, Prof. Moraes Rego Avenue, 1235 - Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil
| | - Marcella Campos Lima da Luz
- Federal University of Pernambuco, Prof. Moraes Rego Avenue, 1235 - Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil
| | | | - Poliana Coelho Cabral
- Federal University of Pernambuco, Prof. Moraes Rego Avenue, 1235 - Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil
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Meng D, Jin Z, Chen K, Yu X, Wang Y, Du W, Wei J, Xi J, Fang B. Quality of life predicts rehabilitation prognosis in Parkinson's disease patients: Factors influence rehabilitation prognosis: Factors influence rehabilitation prognosis. Brain Behav 2022; 12:e2579. [PMID: 35429406 PMCID: PMC9120870 DOI: 10.1002/brb3.2579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/14/2022] [Accepted: 03/20/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Rehabilitation has been reported to improve the quality of life (QoL) of patients with Parkinson's disease (PD). Nevertheless, not all patients are satisfied with rehabilitation outcomes and could achieve a significant improvement in QoL. OBJECTIVE To detect possible predictors of QoL improvement in patients with PD after rehabilitation. METHODS A total of 86 PD patients were included and followed up for 3 months with a 39-item Parkinson's Disease Questionnaire summary index (PDQ-39 SI) as the primary endpoint. All patients received 2 weeks of multidisciplinary intensive rehabilitation treatment (MIRT). Changes in patients' QoL were assessed using the PDQ-39 at baseline and at the 3-month follow-up. The reliable change index (RCI) was adapted to determine the individual QoL outcome. The predictors of QoL outcome were detected using logistic regression analysis. RESULTS After a 3-month follow-up, PDQ-39 SI decreased significantly from 22.95 ± 9.75 to 18.73 ± 10.32 (P < 0.001). Scores for QoL improved (RCI>10.9) after rehabilitation for 18.6% of the patients, and 74.4% of patients reported an unchanged QoL (-10.9≤RCI≤10.9), while 7.0% of patients reported a worsening of QoL (RCI<-10.9). Among the baseline parameters, the PDQ-39 SI was a baseline predictor for changes in QoL in the logistic regression model (OR: 1.15, CI: 1.07-1.24, P < 0.001). CONCLUSIONS MIRT could improve QoL for some patients with PD, and PDQ-39 score at baseline is the most important predictor for QoL improvements after rehabilitation for this patients.
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Affiliation(s)
- Detao Meng
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Jin
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Keke Chen
- Beijing Rehabilitation Medical College, Capital Medical University, Beijing, China
| | - Xin Yu
- Beijing Rehabilitation Medical College, Capital Medical University, Beijing, China
| | - Yixuan Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Wenjun Du
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jingran Wei
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jianing Xi
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Boyan Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
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Stathis P, Papadopoulos G. Evaluation and validation of a patient-reported quality-of-life questionnaire for Parkinson's disease. J Patient Rep Outcomes 2022; 6:17. [PMID: 35235090 PMCID: PMC8891413 DOI: 10.1186/s41687-022-00427-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/24/2022] [Indexed: 12/25/2022] Open
Abstract
Background Parkinson’s disease (PD) is a chronic, progressive illness with a profound impact on the health-related quality of life (HRQoL). Disease-specific patient-reported HRQoL measures, such as PDQ-39 and its short version PDQ-8, are increasingly used in clinical practice to address the consequences of PD on everyday life. Due to limitations in the content, especially in non-motor symptoms and sleep disturbances of PDQ-8, PDQoL7, a 7-item, short-term, self-reported, PD-specific HRQoL questionnaire was developed. Methods A representative sample of 60 adults with idiopathic PD completed the PDQoL7 questionnaire and the existing validated PDQ-8 and EQ-5D-5L questionnaires (all in Greek). Results PDQoL7 summary index strongly correlated with PDQ-8 (rs = 0.833, P < 0.001) and EQ-5D-5L (rs = − 0.852, P < 0.001). The correlation between PDQoL7 and EQ-5D-5L was statistically significantly stronger compared to PDQ-8 and EQ-5D-5L (rs = − 0.852 vs rs = − 0.789 respectively, P < 0.001). The internal consistency of PDQoL7 was not affected by item deletion (positive item to total correlations: 0.29–0.63). No redundant items (with inter-item correlation coefficients greater than 0.80) were identified. Cronbach’s α for PDQoL7 was comparable to PDQ-8 (0.804 versus 0.799 respectively). As PDQoL7 had three-dimensional structure, omega coefficient analysis confirmed its reliability (omega total: 0.88; omega hierarchical: 0.58). Conclusions PDQoL7 is an acceptable, easy to use, valid and reliable tool for the determination of HRQoL in PD patients that is potentially more comprehensive than PDQ-8 based on the available evidence. PDQoL7 could allow for a more thorough evaluation of the impact of PD and contribute to guiding healthcare decisions. This will be confirmed in subsequent analysis on larger patient cohorts. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00427-0.
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Affiliation(s)
- Pantelis Stathis
- Department of Neurology, Mediterraneo Hospital, 8-12 Ilias Street, 16675, Glyfada, Athens, Greece.
| | - George Papadopoulos
- Department of Neurology, Mediterraneo Hospital, 8-12 Ilias Street, 16675, Glyfada, Athens, Greece
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Meng D, Jin Z, Gao L, Wang Y, Wang R, Fang J, Qi L, Su Y, Liu A, Fang B. The quality of life in patients with Parkinson's disease: Focus on gender difference. Brain Behav 2022; 12:e2517. [PMID: 35138047 PMCID: PMC8933778 DOI: 10.1002/brb3.2517] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/14/2021] [Accepted: 01/22/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To improve understanding of gender differences on quality of life (QoL) in patients with Parkinson's disease (PWP) of a different race, the differences of clinical features and health-related quality of life (HRQoL) between male and female PWP were studied in a small cohort early to middle stage of Chinese PWP. METHODS A cross-sectional study was carried out. PWP were consecutively included from April 2020 to July 2021 in Beijing Rehabilitation Hospital. HRQoL, motor symptoms, and nonmotor symptoms in each patient were evaluated. The differences of demographic, motor symptoms assessments, nonmotor symptoms assessments, and QoL between two gender groups were tested using t-test statistics, Mann-Whitney-Wilcoxon test, or χ2 depending on the data type. To eliminate the possible factors contributing to the QoL, linear regression models were constructed to sort out the effect of gender. RESULTS One hundred and sixty-two Parkinson's disease (PD) patients were included. Demographic, clinical characteristics, and symptom scale assessments had no statistical differences except for levodopa equivalent daily dose, Hamilton Anxiety Rating Score, REM sleep behavior disorder sleep questionnaire, and Hyposmia Rating Scale score. After baseline imbalance corrections, a significantly higher score of PD Questionnaire-39 (PDQ-39) in female than in male patients(p<.05) was found. In the questionnaire, summary Index and bodily discomfort, stigma, and emotional well-being subscores were the main contribution differences. CONCLUSIONS Gender differences are associated with the QoL in the early to middle stage PWP in China. Female patients have poorer QoL than male patients, especially bodily discomfort, stigma, and emotional well-being.
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Affiliation(s)
- Detao Meng
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Jin
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Lei Gao
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yixuan Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Ruidan Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jinping Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Lin Qi
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yuan Su
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Aixian Liu
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Boyan Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
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Lee KS, Clennell B, Steward TGJ, Gialeli A, Cordero-Llana O, Whitcomb DJ. Focused Ultrasound Stimulation as a Neuromodulatory Tool for Parkinson's Disease: A Scoping Review. Brain Sci 2022; 12:289. [PMID: 35204052 PMCID: PMC8869888 DOI: 10.3390/brainsci12020289] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
Non-invasive focused ultrasound stimulation (FUS) is a non-ionising neuromodulatory technique that employs acoustic energy to acutely and reversibly modulate brain activity of deep-brain structures. It is currently being investigated as a potential novel treatment for Parkinson's disease (PD). This scoping review was carried out to map available evidence pertaining to the provision of FUS as a PD neuromodulatory tool. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews, a search was applied to Ovid MEDLINE, Embase, Web of Science and Cochrane Central Register of Controlled Trials on 13 January 2022, with no limits applied. In total, 11 studies were included: 8 were from China and 1 each from Belgium, South Korea and Taiwan. All 11 studies were preclinical (6 in vivo, 2 in vitro, 2 mix of in vivo and in vitro and 1 in silico). The preclinical evidence indicates that FUS is safe and has beneficial neuromodulatory effects on motor behaviour in PD. FUS appears to have a therapeutic role in influencing the disease processes of PD, and therefore holds great promise as an attractive and powerful neuromodulatory tool for PD. Though these initial studies are encouraging, further study to understand the underlying cellular and molecular mechanisms is required before FUS can be routinely used in PD.
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Affiliation(s)
- Keng Siang Lee
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UK; (K.S.L.); (B.C.); (T.G.J.S.); (A.G.); (O.C.-L.)
- Regenerative Medicine Laboratory, School of Clinical Sciences, University of Bristol, Bristol BS8 1TH, UK
- Institute of Clinical Neurosciences, Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol BS8 1TH, UK
| | - Benjamin Clennell
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UK; (K.S.L.); (B.C.); (T.G.J.S.); (A.G.); (O.C.-L.)
- Institute of Clinical Neurosciences, Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol BS8 1TH, UK
| | - Tom G. J. Steward
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UK; (K.S.L.); (B.C.); (T.G.J.S.); (A.G.); (O.C.-L.)
- Institute of Clinical Neurosciences, Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol BS8 1TH, UK
| | - Andriana Gialeli
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UK; (K.S.L.); (B.C.); (T.G.J.S.); (A.G.); (O.C.-L.)
- Regenerative Medicine Laboratory, School of Clinical Sciences, University of Bristol, Bristol BS8 1TH, UK
| | - Oscar Cordero-Llana
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UK; (K.S.L.); (B.C.); (T.G.J.S.); (A.G.); (O.C.-L.)
- Regenerative Medicine Laboratory, School of Clinical Sciences, University of Bristol, Bristol BS8 1TH, UK
| | - Daniel J. Whitcomb
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UK; (K.S.L.); (B.C.); (T.G.J.S.); (A.G.); (O.C.-L.)
- Institute of Clinical Neurosciences, Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol BS8 1TH, UK
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Boussac M, Arbus C, Dupouy J, Harroch E, Rousseau V, Ory-Magne F, Rascol O, Moreau C, Maltête D, Rouaud T, Meyer M, Houvenaghel JF, Marsé C, Tranchant C, Hainque E, Jarraya B, Ansquer S, Bonnet M, Belamri L, Tir M, Marques AR, Danaila T, Eusebio A, Devos D, Brefel-Courbon C. Personality Dimensions Are Associated with Quality of Life in Fluctuating Parkinson's Disease Patients (PSYCHO-STIM). JOURNAL OF PARKINSONS DISEASE 2021; 10:1057-1066. [PMID: 32444557 DOI: 10.3233/jpd-191903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Parkinson's disease (PD) negatively affects patients' Quality of Life (QoL) which depends on both objective criteria such as physical health and subjective ones such as worries and norms according to personal believes. Therefore, QoL could be also associated to personality dimensions in chronic neurological diseases such as PD. OBJECTIVE Our objective was thus to study the potential association between personality dimensions and QoL in PD patients with motor fluctuations before Deep Brain Stimulation of the Sub-Thalamic Nucleus (DBS-STN). METHODS Data were obtained from the French multicentric cohort study Predi-Stim. All PD patients awaiting DBS-STN and responding to the inclusion criteria at the time of the study were included. All participants answered the "Temperament and Character Inventory" (TCI) and the PDQ-39 before surgery. Analyses were made using adjusted univariate generalized linear regression models to evaluate a potential association between TCI dimensions and PDQ-39 scores. RESULTS Three hundred thirty-three consecutive patients were included. The temperament Harm Avoidance was negatively associated with QoL (p = 1e-4, R2= 0.33), whereas the character Self-Directedness was positively associated with mental component of QoL (p = 2e-4, R2= 0.33) in PD patients with motor fluctuations awaiting DBS-STN. CONCLUSIONS PD patients with motor fluctuations, with lower Harm Avoidance and higher Self-Directedness scores have the best QoL mainly at an emotional and social level. Therapeutic education of these PD patients focusing on their personal resources may thus be important to improve their well-being.
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Affiliation(s)
- Mathilde Boussac
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Christophe Arbus
- Psychiatry Department of the University Hospital of Toulouse, CHU Purpan, Toulouse, France
| | - Julia Dupouy
- Department of Clinical Pharmacology and Neurosciences, Centre d'Investigation Clinique CIC1436, University Hospital of Toulouse, Toulouse, France
| | - Estelle Harroch
- Department of Clinical Pharmacology and Neurosciences, Centre d'Investigation Clinique CIC1436, University Hospital of Toulouse, Toulouse, France
| | - Vanessa Rousseau
- Department of Clinical Pharmacology and Neurosciences, Centre d'Investigation Clinique CIC1436, University Hospital of Toulouse, Toulouse, France
| | - Fabienne Ory-Magne
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France.,Psychiatry Department of the University Hospital of Toulouse, CHU Purpan, Toulouse, France.,Department of Clinical Pharmacology and Neurosciences, Centre d'Investigation Clinique CIC1436, University Hospital of Toulouse, Toulouse, France
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neurosciences, Centre d'Investigation Clinique CIC1436, University Hospital of Toulouse, Toulouse, France
| | - Caroline Moreau
- CHU of Lille, Univ. Lille, Inserm UMRS_1171, Licend, Department of Medical Pharmacology, Neurology and Movement Disorders Department, Referent Center of Parkinson's Disease, Lille, France
| | - David Maltête
- Department of Neurology, Rouen University Hospital and University of Rouen, France; INSERM U1239, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan, France
| | - Tiphaine Rouaud
- Clinique Neurologique, Hôpital Guillaume et René Laennec, Boulevard Jacques Monod, Nantes Cedex
| | - Mylène Meyer
- Neurology Department, Nancy University Hospital, Nancy, France
| | - Jean Francois Houvenaghel
- Behavior and Basal Ganglia" Research Unit (EA 4712), University of Rennes 1, Rennes, France; Department of Neurology, Rennes University Hospital, Rennes Cedex, France
| | - Claire Marsé
- CHU Nice, Centre Expert Parkinson, Service de Neurologie, Nice, France
| | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France; Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Elodie Hainque
- Département de Neurologie, Hôpital Pitié-Salpêtrière, AP-HP, Faculté de Médecine de Sorbonne Université, UMR S 1127, Inserm U 1127, and CNRS UMR 7225, and Institut du Cerveau et de la Moëlle épinière, Paris, France
| | - Béchir Jarraya
- Pôle Neurosciences, Foch Hospital, Suresnes, France; Université de Versailles Paris-Saclay, INSERM U992, CEA Neurospin, Paris, France
| | - Solène Ansquer
- Service de Neurologie, Centre Expert Parkinson, CIC-INSERM 1402, CHU Poitiers, Poitiers, France
| | - Marie Bonnet
- CHU de Bordeaux, Centre Expert Parkinson, Institut des maladies neuro-dégénératives, Bordeaux, France
| | - Lhaouas Belamri
- Hôpital Fondation A de Rothschild, service de recherche clinique, F-75019 Paris, France
| | - Mélissa Tir
- Department of Neurology, Department of Neurosurgery, Expert Centre for Parkinson's Disease, Amiens University Hospital, EA 4559 Laboratoire de Neurosciences Fonctionnelles et Pathologie (LNFP) Université de Picardie Jules Verne, University of Picardy Jules Verne (UPJV), Amiens, France
| | - Ana-Raquel Marques
- Université Clermont Auvergne, EA7280, Clermont-Ferrand University Hospital, Neurology Department, Clermont-Ferrand, France
| | - Teodor Danaila
- Centre Expert Parkinson, Hôpital Neurologique "Pierre Wertheimer", Hospices Civils de Lyon, Bron, France
| | - Alexandre Eusebio
- Aix Marseille Université, AP-HM, Hôpital de La Timone, Service de Neurologie et Pathologie du Mouvement, and UMR CNRS 7289, Institut de Neuroscience de La Timone, Marseille, France
| | - David Devos
- CHU of Lille, Univ. Lille, Inserm UMRS_1171, Licend, Department of Medical Pharmacology, Neurology and Movement Disorders Department, Referent Center of Parkinson's Disease, Lille, France
| | - Christine Brefel-Courbon
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France.,Psychiatry Department of the University Hospital of Toulouse, CHU Purpan, Toulouse, France.,Department of Clinical Pharmacology and Neurosciences, Centre d'Investigation Clinique CIC1436, University Hospital of Toulouse, Toulouse, France
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Santa Rosa Malcher CM, Roberto da Silva Gonçalves Oliveira K, Fernandes Caldato MC, Lopes Dos Santos Lobato B, da Silva Pedroso J, de Tubino Scanavino M. Sexual Disorders and Quality of Life in Parkinson's Disease. Sex Med 2021; 9:100280. [PMID: 33429240 PMCID: PMC7930860 DOI: 10.1016/j.esxm.2020.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/11/2020] [Accepted: 10/19/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Sexual disorders are the most neglected nonmotor symptoms in Parkinson's disease (PD). Although doctors seek greater priority to motor manifestations, which are the basis for the diagnosis of PD, the nonmotor symptoms deserve to be highlighted as much as the motor problems because of their strong presence and discomfort in the patients, causing the important impairment in the quality of life (QoL) of the individual with PD. Aim Provide the prevalence of sexual disorders among patients with PD and alert the medical profession to investigate and be familiar with problems related to QoL and sexual disorders in PD. Methods This is a large literature review on sexual disorders in PD and impaired QoL. Main Outcome Measures Sexual disorders in PD and prevalence between genders have been described in epidemiological studies. Neuroanatomy, pathophysiology, risk factors, QoL, and etiologies were reviewed. Results The estimate of the prevalence of sexual dysfunction in the form of compulsive sexual behavior in PD is higher in men by 5.2% than in women by 0.5%. This diagnosis is a determinant of intense and persistent suffering and is related to several health problems of a social, economic, personal, family, psychological, and occupational nature, which can even culminate in sexual abuse. It is most commonly associated with the use of drugs commonly used in PD therapy in 98.1% of cases. In addition to this serious public health problem, another common condition of sexual dysfunction occur with the decreased libido by loss of the neurotransmitter dopamine proper of the pathophysiology of PD. Conclusion The presence of sexual disorders in PD should be tracked and monitored because of its harmful consequences, whether due to increased sexual behavior or associated psychological distress, as well as the impacts on QoL. Early recognition and adequate treatment of PD in its fullness and richness of associated symptoms are essential for improving QoL. Santa Rosa Malcher CM, Roberto da Silva Gonçalves Oliveira K, Fernandes Caldato MC, et al. Sexual Disorders and Quality of Life in Parkinson's Disease. Sex Med 2021;9:100280.
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Knudson M, Thomsen TH, Kjaer TW. Comparing Objective and Subjective Measures of Parkinson's Disease Using the Parkinson's KinetiGraph. Front Neurol 2020; 11:570833. [PMID: 33250843 PMCID: PMC7674832 DOI: 10.3389/fneur.2020.570833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/01/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Parkinson's disease (PD) is a neurodegenerative disease that can lead to impaired motor function and execution of activities of daily living (ADL). Since clinicians typically can only observe patients' symptoms during visits, prescribed medication schedules may not reflect the full range of symptoms experienced throughout the day. Therefore, objective tools are needed to provide comprehensive symptom data to optimize treatment. One such tool is the Parkinson's KinetiGraph® (PKG), a wearable sensor that measures motor symptoms of Parkinson's disease. Objective: To build a mathematical model to determine if PKG data measuring Parkinson's patients' motor symptoms can predict patients' ADL impairment. Methods: Thirty-four patients with PD wore the PKG device for 6 days while performing their ADL. Patients' PKG scores for bradykinesia and dyskinesia, as well as their responses to a questionnaire asking if their ADL-level had been impacted by various motor symptoms, were used to build a multiple regression model predicting the patients' Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part II scores. Results: Calculation of bradykinesia score response to medication showed that using a dosage response time of 30 min yielded a greater bradykinesia response than when the response time was set to 40, 50, 60, 70, 80, or 90 min. The overall multiple regression model predicting MDS-UPDRS part II score was significant (R2 = 0.546, p < 0.001). Conclusion: The PKG's ability to provide motor symptom data that correlates with clinical measures of ADL impairment suggests that it has strong potential as a tool for the assessment and management of Parkinson's disease motor symptoms.
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Affiliation(s)
- Mei Knudson
- Department of Mathematics and Statistics, Carleton College, Northfield, MN, United States.,DIS Copenhagen, Copenhagen, Denmark.,Department of Clinical Neurophysiology and Neurology, Zealand University Hospital, Roskilde, Denmark
| | - Trine Hoermann Thomsen
- Department of Clinical Neurophysiology and Neurology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
| | - Troels Wesenberg Kjaer
- DIS Copenhagen, Copenhagen, Denmark.,Department of Clinical Neurophysiology and Neurology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
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10
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Martinez-Martin P, Deuschl G, Tonder L, Schnitzler A, Houeto JL, Timmermann L, Rau J, Schade-Brittinger C, Stoker V, Vidailhet M, Krack P. Interpretation of health-related quality of life outcomes in Parkinson's disease from the EARLYSTIM Study. PLoS One 2020; 15:e0237498. [PMID: 32822437 PMCID: PMC7442251 DOI: 10.1371/journal.pone.0237498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/27/2020] [Indexed: 11/23/2022] Open
Abstract
The EARLYSTIM Study compared deep brain stimulation (DBS) with best medical treatment (BMT) over 2-years, showing a between-group difference of 8.0 from baseline in favor of DBS in health-related quality of life (HRQoL), measured with the PDQ-39 SI (summary index). This study obtained complementary information about the importance of the change in HRQoL as measured by the PDQ-39, using anchor-based (Patient Global Impression of Change, PGIC) and distribution-based techniques (magnitude of change, effect size, thresholds, distribution of benefit) applied to the EARLYSTIM study data. Anchor-based techniques showed a difference follow-up-baseline for patients who reported "minimal improvement" of -5.8 [-9.9, -1.6] (mean [95%CI]) in the DBS group vs -2.9 [-9.0, 3.1] in the BMT group. As the vast majority (80.8%) of DBS patients reported "much or very much improvement", this difference was explored for the latter group and amounted to -8.7 for the DBS group and -6.5 in the BMT group. Distribution-based techniques that analyzed the relative change and treatment effect size showed a moderate benefit of the DBS on the HRQoL, whereas a slight worsening was observed in the BMT group. The change in the DBS group (-7.8) was higher than the MIC (Minimally Important Change) estimated value (-5.8 by the anchor; -6.3 by triangulation of thresholds), but not in the BMT (0.2 vs. -3.0 to -5.4, respectively). Almost 90% of the patients in the DBS group declared some improvement (58.3% and 56.7% beyond the estimated MIC), which was significantly different from the BMT group whose proportions were 32.0% and 30.3%, respectively. The number needed to treat to improve ≥1 MIC by DBS vs BMT was 3.8. Change in depression, disability and pain influenced the improvement of the DBS group. DBS improved HRQoL in a high proportion of patients to a significant and moderate degree, at 2 years follow-up.
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Affiliation(s)
- Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Guenther Deuschl
- Department of Neurology, UKSH, Kiel Campus Christian-Albrechts-University, Kiel, Germany
| | - Lisa Tonder
- Medtronic, Minneapolis, Minnesota, United States of America
| | - Alfons Schnitzler
- Department of Neurology, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - Jean-Luc Houeto
- Department of Neurology, CIC-INSERM 1402, CHU of Poitiers, University of Poitiers, Poitiers, France
| | - Lars Timmermann
- Universitätsklinikum Giessen und Marburg, Marburg Campus, Marburg, Germany
| | - Joern Rau
- The Coordinating Center for Clinical Trials, Philipps University, Marburg, Germany
| | | | - Valerie Stoker
- Medtronic, Minneapolis, Minnesota, United States of America
| | - Marie Vidailhet
- Department of Neurology, Sorbonne Université, ICM UMR1127, INSERM &1127, CNRS 7225, Salpêtriere University Hospital, AP-HP, Paris, France
| | - Paul Krack
- Department of Neurology, University Hospital Bern, University of Bern, Bern, Switzerland
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11
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Association of Motor and Cognitive Symptoms with Health-Related Quality of Life and Caregiver Burden in a German Cohort of Advanced Parkinson's Disease Patients. PARKINSONS DISEASE 2020; 2020:5184084. [PMID: 32184980 PMCID: PMC7060449 DOI: 10.1155/2020/5184084] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/24/2020] [Accepted: 01/30/2020] [Indexed: 12/17/2022]
Abstract
Parkinson's disease (PD) is a chronic progressive movement disorder with severe reduction in patients' health-related quality of life (HR-QoL). Motor and cognitive symptoms are especially linked with decreased PD patients' HR-QoL. However, the relationship of these symptoms to caregiver burden is relatively unclear. Influence of the Montreal Cognitive Assessment scale (MoCA) as a cognitive screening tool and Movement Disorders Society Unified Parkinson's disease Rating Scale MDS-UPDRS symptoms in relation to patients' HR-QoL and caregivers` burden was analyzed. PD patients (n = 124) completed MDS-UPDRS, MoCA, and the PD questionnaire 8 (PDQ-8) as a measure of quality of life. Caregivers (n = 78) were assessed by the PD caregiver burden inventory (PDCB). PDQ-8 and PDCB scores were regressed on MDS-UPDRS subscales and MoCA subscores. PDQ-8 correlated with attention (R2 0.1282; p < 0.001) and executive (R2 0.0882; p 0.001) MoCA subscores and all parts of the MDS-UPDRS. PDCB correlated most strongly with MDS-UPDRS part III motor symptoms (R2 0.2070; p < 0.001) and the MoCA attention subscore (R2 0.1815; p < 0.001). While all facets of PD symptoms assessed by the MDS-UPDRS relate to PD patients' quality of life, motor symptoms are the most relevant factor for the prediction of caregiver burden. In addition, patients' attentional symptoms seem to affect not only them, but also their caregivers. These findings show the potential of a detailed analysis of MDS-UPDRS and MoCA performance in PD patients.
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12
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Hicks A, Phillips K, Siwik C, Salmon P, Litvan I, Jablonski ME, Filoteo JV, Kayser K, Sephton SE. The role of dispositional mindfulness in a stress-health pathway among Parkinson's disease patients and caregiving partners. Qual Life Res 2019; 28:2705-2716. [PMID: 31201728 DOI: 10.1007/s11136-019-02217-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE Parkinson's disease (PD) patients and their caregivers experience significant distress that impacts physical, emotional and social functioning in the patient, and in turn, has a significant impact on the caregiver. Lower levels of stress have been associated with a better prognosis in PD. The quality of dispositional mindfulness-innate present moment, non-judgmental awareness-has consistently been associated with less perceived stress, greater well-being, and better physical health in both clinical and healthy populations. To date, associations of mindfulness with distress, depression, sleep problems, and other variables that define health-related quality of life have not been examined in the context of PD patient/caregiver dyads. METHODS We investigated the impact of dispositional mindfulness in a stress-health model among eighteen dyads consisting of PD patients and their caregivers. RESULTS Multilevel linear modeling (actor-partner interdependence models) revealed significant associations between dispositional mindfulness and stress appraisal, interpersonal support, depressive symptoms, sleep, and health-related quality of life (HRQOL) within both dyadic partners. As expected, results demonstrated significant associations of distress with interpersonal support, depressive symptoms, sleep and HRQOL for both PD patients and caregivers. CONCLUSIONS Dispositional mindfulness was associated with reduced distress and its downstream clinical consequences. These results support an ameliorative role for dispositional mindfulness among PD patients and caregivers, as a protective factor against psychosocial burdens imposed on couples related to disease and caregiving. Findings suggest future studies should explore mindfulness training as a therapeutic option.
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Affiliation(s)
- Allison Hicks
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Kala Phillips
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Chelsea Siwik
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Paul Salmon
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Irene Litvan
- Department of Neurology, University of California San Diego, San Diego, CA, USA
| | - Megan E Jablonski
- Department of Psychology, Frazier Rehabilitation Hospital, Louisville, KY, USA
| | - J Vincent Filoteo
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Karen Kayser
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Sandra E Sephton
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, USA.
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13
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Sociodemographic Factors Affecting the Disease Acceptance and the Quality of Life in Patients With Parkinson's Disease: A Preliminary Study. Rehabil Nurs 2019; 44:35-46. [PMID: 29782477 DOI: 10.1097/rnj.0000000000000149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Parkinson's disease (PD) significantly affects functioning of patients, thereby lowering their quality of life. The aim of this study was to evaluate the influence of sociodemographic variables on illness acceptance and quality of life in patients with idiopathic PD. DESIGN This is a cross-sectional research study. METHODS The study was conducted with 50 patients with PD. The diagnostic survey method was applied for the purposes of this study with the use of the Parkinson's Disease Questionnaire, the Acceptance of Illness Scale, and a study-specific demographic questionnaire that included questions about sociodemographic data. Multivariable logistic regression was derived to define independent predictors of quality of life. FINDINGS Men assessed quality of life in the bodily discomfort domain as significantly worse than women (p = .0214). Age negatively and significantly affected the assessment of quality of life in particular domains. Professionally active respondents significantly more often accepted their disease than others (p = .0070). CONCLUSIONS AND CLINICAL RELEVANCE Being professionally active, living in urban areas, and having higher education and higher financial status increase subjective assessment of quality of life in patients with PD. Knowing the impact of sociodemographic variables on quality of life allows rehabilitation nurses to plan nursing and rehabilitation activities more effectively and in line with the capacity of a patient and caregivers.
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14
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Faria SMD, Maximiano-Barreto MA, Morais DD, Chagas MHN. Impacto dos sintomas de ansiedade na qualidade de vida na doença de Parkinson: uma revisão sistemática. JORNAL BRASILEIRO DE PSIQUIATRIA 2019. [DOI: 10.1590/0047-2085000000224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
RESUMO Objetivo: Revisar estudos relacionados ao impacto da ansiedade na qualidade de vida em pacientes com doença de Parkinson. Métodos: Trata-se de uma revisão sistemática realizada nos bancos de dados PubMed, Scopus, Web of Science e PsycINFO, com os descritores: “anxiety”, “Parkinson's disease” e “quality of life”. Foram selecionados 20 artigos publicados em inglês e sem limite de tempo. Resultado: A maioria dos estudos demonstrou correlação direta entre ansiedade e qualidade de vida em indivíduos com doença de Parkinson. Apenas dois estudos não encontraram essa associação. A presença de sintomas de ansiedade parece estar relacionada com a gravidade dos sintomas motores, sexo feminino e idade mais jovem, levando a um impacto maior na qualidade de vida. Conclusão: Os artigos analisados mostraram que a ansiedade tem impacto negativo sobre a qualidade de vida de indivíduos com doença de Parkinson.
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Affiliation(s)
| | | | | | - Marcos Hortes Nisihara Chagas
- Universidade de São Paulo, Brasil; Universidade Federal de São Carlos, Brasil; Universidade Federal de São Carlos, Brasil
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15
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Diniz JG, da Silva AC, Nóbrega AC. Quality of life and swallowing questionnaire for individuals with Parkinson's disease: development and validation. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:864-874. [PMID: 29781565 DOI: 10.1111/1460-6984.12395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Individuals with Parkinson's disease (PD) may exhibit some degree of change in swallowing dynamics during the course of the disease. These changes can affect their physical, functional and emotional quality of life. AIMS To develop a quality of life and swallowing questionnaire for individuals with PD. METHODS & PROCEDURES The first version of the questionnaire comprised 29 items taken from the accounts of 50 patients treated over a 2-month period at Sarah Hospital in Salvador, Bahia, Brazil. A committee of 10 experts in the field analyzed the content and reduced the questionnaire to 28 questions. The questionnaire was then administered to 140 PD patients and 47 healthy individuals. A factor analysis of the items guided the drafting of the final questionnaire, which consisted of 19 items grouped into four factors, encompassing physical, functional and emotional aspects. A test-retest assessment was conducted with 44 individuals with PD. OUTCOMES & RESULTS The internal consistency, estimated by the mean of Cronbach's alpha coefficient, varied between 0.71 (domain 3) and 0.94 (domain 1) in the test and between 0.69 (domain 3) and 0.95 (domain 1) in the retest. The correlation coefficient in the test/retest comparison was high and significant, demonstrating that the measurement was stable. A significant difference was observed between the PD group and the comparison group. CONCLUSIONS & IMPLICATIONS The questionnaire developed is a valid, statistically appropriate and clinically effective self-administered instrument for individuals with PD.
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Affiliation(s)
- Juliana Garcia Diniz
- SARAH Network of Rehabilitation Hospitals, Caminho das Árvores, Salvador, Bahia, Brazil
| | | | - Ana Caline Nóbrega
- Department of Speech-Language and Hearing Sciences-Health Sciences Institute, Federal University of Bahia, Canela, Salvador, Bahia, Brazil
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16
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Tibar H, El Bayad K, Bouhouche A, Ait Ben Haddou EH, Benomar A, Yahyaoui M, Benazzouz A, Regragui W. Non-Motor Symptoms of Parkinson's Disease and Their Impact on Quality of Life in a Cohort of Moroccan Patients. Front Neurol 2018; 9:170. [PMID: 29670566 PMCID: PMC5893866 DOI: 10.3389/fneur.2018.00170] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/06/2018] [Indexed: 12/26/2022] Open
Abstract
Background Non-motor symptoms (NMSs) are a real burden in Parkinson’s disease (PD). They may appear in early pre-symptomatic stage as well as throughout the disease course. However, their relationship with the deterioration of the patient’s quality of life (QoL) is still under debate. This study aimed to investigate the prevalence of NMSs and their impact on the QoL in a cohort of Moroccan patients. Methods We carried out a cross-transactional study, where a total of 117 patients were submitted to a structured clinical interview and examination investigating motor and NMSs based on common and conventional scales. Motor symptoms were assessed by the UPDRS I–VI during ON condition. The NMSs were evaluated with common scales and their relationship with the QoL was investigated. Results The mean patient’s age was 60.77 ± 11.36 years old, and the median disease duration was 6 years [2.5–9.5]. Motor’s phenotype subtypes were the mixed form in 40.2% of patients, akinetic-rigid in 20.5% and a tremor-dominant form in 39.3%. The median Hoehn and Yahr staging was 2 [1–2.5]. Regarding NMSs, the most common were urinary dysfunctions (82.6%), sleep (80.6%), and gastrointestinal (80%) disorders. Other autonomic dysfunctions were also frequent: thermoregulatory dysfunctions 58.6%, cardiovascular troubles 50.9%, and sexual dysfunctions 47.9%. Depression was present in 47.9% and fatigue symptoms in 23.1%. The median score of SCOPA-AUT was 14 [7.75–21.80]. The median PD questionnaire 39-score index (PDQ39-SI) was 23.22% and the most affected dimension was “mobility.” Univariate and multivariate analyses showed that the SCOPA-AUT score impacted the QoL (p = 0.001), especially the gastrointestinal (p = 0.007), and cardiovascular (p = 0.049) dimensions. Conclusion Our data show that all patients have presented at least one NMS. Autonomic and sleep disorders were the most frequent, and in contrast to other studies, digestive and cardiovascular disorders were rather the factors influencing negatively the QoL of patients. Understanding the pathophysiology of these NMSs should be placed at the forefront in order to develop new therapeutic approaches by improving the QoL of PD patients.
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Affiliation(s)
- Houyam Tibar
- Research Team in Neurology and Neurogenetics, Faculty of Medicine and Pharmacy, Genomics Center of Human Pathologies, University Mohammed V, Rabat, Morocco.,Department of Neurology and Neurogenetics, Hôpital des spécialités de Rabat, Rabat, Morocco.,University de Bordeaux, Institut des maladies neurodégénératives, UMR 5293, Bordeaux, France.,CNRS, Institut des maladies neurodégénératives, UMR 5293, Bordeaux, France
| | - Khalil El Bayad
- Department of Neurology and Neurogenetics, Hôpital des spécialités de Rabat, Rabat, Morocco
| | - Ahmed Bouhouche
- Research Team in Neurology and Neurogenetics, Faculty of Medicine and Pharmacy, Genomics Center of Human Pathologies, University Mohammed V, Rabat, Morocco.,Department of Neurology and Neurogenetics, Hôpital des spécialités de Rabat, Rabat, Morocco
| | - El Hachmia Ait Ben Haddou
- Research Team in Neurology and Neurogenetics, Faculty of Medicine and Pharmacy, Genomics Center of Human Pathologies, University Mohammed V, Rabat, Morocco.,Department of Neurology and Neurogenetics, Hôpital des spécialités de Rabat, Rabat, Morocco
| | - Ali Benomar
- Research Team in Neurology and Neurogenetics, Faculty of Medicine and Pharmacy, Genomics Center of Human Pathologies, University Mohammed V, Rabat, Morocco.,Department of Neurology and Neurogenetics, Hôpital des spécialités de Rabat, Rabat, Morocco
| | - Mohamed Yahyaoui
- Research Team in Neurology and Neurogenetics, Faculty of Medicine and Pharmacy, Genomics Center of Human Pathologies, University Mohammed V, Rabat, Morocco.,Department of Neurology and Neurogenetics, Hôpital des spécialités de Rabat, Rabat, Morocco
| | - Abdelhamid Benazzouz
- University de Bordeaux, Institut des maladies neurodégénératives, UMR 5293, Bordeaux, France.,CNRS, Institut des maladies neurodégénératives, UMR 5293, Bordeaux, France
| | - Wafa Regragui
- Research Team in Neurology and Neurogenetics, Faculty of Medicine and Pharmacy, Genomics Center of Human Pathologies, University Mohammed V, Rabat, Morocco.,Department of Neurology and Neurogenetics, Hôpital des spécialités de Rabat, Rabat, Morocco
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17
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Sobreira-Neto MA, Pena-Pereira MA, Sobreira EST, Chagas MHN, Fernandes RMF, Tumas V, Eckeli AL. High Frequency of Sleep Disorders in Parkinson's Disease and Its Relationship with Quality of Life. Eur Neurol 2017; 78:330-337. [PMID: 29084403 DOI: 10.1159/000481939] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/03/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To determine the frequency of major sleep disorders in patients with Parkinson's disease (PD), diagnosed according to the third international classification of sleep disorders, and assess the relationship of those disorders with the quality of life. METHODS A cross-sectional study was performed involving 88 consecutive patients with PD from outpatient clinic. Participants were subjected to clinical interviews, assessment using standardized scales (Epworth Sleepiness Scale, PD Questionnaire, Pittsburgh sleep quality index (PSQI) and, for individuals with a diagnosis of RLS/WED, International RLS/WED grading scale), and video-polysomnography. RESULTS We observed sleep disorders in 96.5% of the participants, with REM-sleep behavior disorder found in 62.5%, obstructive sleep apnea in 62.5%, insomnia in 55.7%, and restless legs syndrome in 28.4%. We observed a correlation between health-related quality of life with the PSQI and the Epworth sleepiness scale. CONCLUSION Patients with PD have a high prevalence of sleep disorders. The quality of sleep and excessive daytime sleepiness significantly affect the quality of life in these individuals.
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Affiliation(s)
- Manoel Alves Sobreira-Neto
- Department of Clinical Medicine, Faculty of Medicine of Federal University of Ceará, Fortaleza, Brazil.,Faculty of Medicine, University of Fortaleza, Fortaleza, Brazil
| | | | | | | | | | - Vitor Tumas
- Department of Neuroscience, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Alan Luiz Eckeli
- Department of Neuroscience, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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18
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Wiesli D, Meyer A, Fuhr P, Gschwandtner U. Influence of Mild Cognitive Impairment, Depression, and Anxiety on the Quality of Life of Patients with Parkinson Disease. Dement Geriatr Cogn Dis Extra 2017; 7:297-308. [PMID: 29118782 PMCID: PMC5662998 DOI: 10.1159/000478849] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/19/2017] [Indexed: 01/03/2023] Open
Abstract
Background Neuropsychiatric symptoms (NPS) and mild cognitive impairment (MCI) are common in Parkinson disease (PD) and have a negative impact on the patient's quality of life (QoL). We aim to describe the effect of NPS and MCI on each other and on QoL. Methods Sixteen MCI and 37 non-MCI PD patients completed different self-assessment questionnaires including the Parkinson's Disease Questionnaire (PDQ-39), the Beck Depression Inventory (BD), the Beck Anxiety Inventory (BAI), and the Self-Report Manic Inventory (SRMI). Linear regression with stepwise elimination was used to select the significant predictors of QoL and to control for confounding factors. Results The significant linear regression model (R2 = 0.68, p ≤ 0.01) revealed significant effects of MCI (p = 0.03), BDI (p ≤ 0.01), BAI (p ≤ 0.01), age (p = 0.03), a trend of SRMI (p = 0.06), and disease duration (p = 0.08) on QoL. Conclusions MCI, anxiety, depression, and age decrease QoL in patients with PD. NPS has the main influence in the prediction of QoL in patients with PD, whereas MCI is only of minor importance.
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Affiliation(s)
- Daniel Wiesli
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Antonia Meyer
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Peter Fuhr
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Ute Gschwandtner
- Department of Neurology, University Hospital Basel, Basel, Switzerland
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19
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Tu XJ, Hwang WJ, Ma HI, Chang LH, Hsu SP. Determinants of generic and specific health-related quality of life in patients with Parkinson's disease. PLoS One 2017. [PMID: 28650957 PMCID: PMC5484474 DOI: 10.1371/journal.pone.0178896] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objectives Generic and disease-specific health-related quality of life (HRQoL) instruments may reflect different aspects of lives in patients with Parkinson’s disease (PD) and thus be associated with different determinants. We used the same cluster of predictors for the generic and disease-specific HRQoL instruments to examine and compare the determinants of HRQoL. Method HRQoL was measured in 92 patients with PD by the 36-item Short-Form Health Survey (SF-36) and the 39-item Parkinson’s Disease Questionnaire (PDQ-39). The predictors included demographic and disease characteristics, and motor and non-motor symptoms. Multiple regression analyses were used to identify HRQoL determinants. Results Depressive symptoms and motor difficulties of daily living were the first two significant determinants for both instruments. The other significant determinant for the SF-36 was fatigue and non-motor difficulties of daily living, and for the PDQ-39 was motor signs of PD. Conclusions The results suggest the importance of the evaluation and intervention focused on depressive symptoms and motor difficulties of daily living in patients with PD. In addition, the SF-36 seems more related to non-motor symptoms, while the PDQ-39 appears more associated with motor symptoms. This information is important for understanding results from these two instruments and for choosing which to use.
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Affiliation(s)
- Xiao-Jing Tu
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Juh Hwang
- Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Ing Ma
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- * E-mail: (SPH); (HIM)
| | - Ling-Hui Chang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Pin Hsu
- Department of Neurology, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
- * E-mail: (SPH); (HIM)
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20
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Pontone GM, Mari Z, Perepezko K, Weiss HD, Bassett SS. Personality and reported quality of life in Parkinson's disease. Int J Geriatr Psychiatry 2017; 32:324-330. [PMID: 27059809 PMCID: PMC5333497 DOI: 10.1002/gps.4475] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/29/2016] [Accepted: 03/02/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Personality affects an individual's ability to cope with the burden of chronic disease. However, the impact of personality on quality of life (QoL) in Parkinson's disease (PD) is not well characterized. The goal of this study is to determine the effect of personality on QoL in PD. METHODS The study included 92 patients with idiopathic PD from Baltimore-Washington area movement disorder neurology clinics. QoL was assessed using the 37-item Parkinson's disease Quality of Life Questionnaire (PDQL) total score, and the Neuroticism-Extraversion-Openness Inventory was used to determine personality traits. RESULTS Step-wise regression models examined the contribution of personality, depression, demographic, and PD variables on PDQL-assessed QoL. Neuroticism, conscientiousness, years of education, and depression explained 42% of the variance in the PDQL total score after adjusting for other disease variables. High neuroticism (β = -0.727, 95% confidence interval (CI) -1.125, -0.328, p < 0.0001) and depression (β = -9.058, 95%CI -17.46, -0.657, p = 0.035) negatively affected the PDQL, while high conscientiousness (β = 0.468, 95%CI 0.078, 0.858, p = 0.019), and years of education (β = 1.441, 95%CI 0.371, 2.510, p = 0.009) were positive factors. CONCLUSIONS Personality can have a positive or negative influence on QoL in PD. PD patients with otherwise similar disease burdens and depressive symptoms may experience different levels of QoL depending on the level of neurotic or conscientious personality traits. Therefore, when interpreting patient responses on the PDQL, it is important to understand whether they reflect aspects of PD, that is, motor impairment and depression, which are amenable to treatment or whether they reflect personality traits.
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Affiliation(s)
- Gregory M. Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zoltan Mari
- Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kate Perepezko
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Howard D Weiss
- Department of Neurology and Neurological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Department of Neurology, Sinai Hospital, Baltimore, MD, USA
| | - Susan S Bassett
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Fereshtehnejad SM. Strategies to maintain quality of life among people with Parkinson's disease: what works? Neurodegener Dis Manag 2016; 6:399-415. [PMID: 27600287 DOI: 10.2217/nmt-2016-0020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Among chronic neurodegenerative disorders, Parkinson's disease (PD) is one of the most difficult and challenging to tackle as several motor and nonmotor features influence the patients' quality of life (QoL) and daily activities. Assessing patients QoL with valid instruments and gathering knowledge about the determinants that affect QoL in individuals with PD are the basis of an efficient caring strategy. In addition to the known motor symptoms, nonmotor disorders must also be comprehensively tracked and targeted for treatment to enhance QoL. A holistic strategy to maintain QoL in people with PD should consist of a multidisciplinary, personalized and patient-centered approach with timely administration of palliative care and efficient involvement of caregivers and family members.
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Affiliation(s)
- Seyed-Mohammad Fereshtehnejad
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences & Society (NVS), Karolinska Institutet, Stockholm, Sweden.,Department of Neurology & Neurosurgery, Faculty of Medicine, McGill University, Montreal General Hospital, Montreal, Québec, Canada
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Foppa AA, Chemello C, Vargas-Peláez CM, Farias MR. Medication Therapy Management Service for Patients with Parkinson's Disease: A Before-and-After Study. Neurol Ther 2016; 5:85-99. [PMID: 27271736 PMCID: PMC4919135 DOI: 10.1007/s40120-016-0046-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Indexed: 12/02/2022] Open
Abstract
Background Parkinson’s disease (PD) is a neurodegenerative disease characterized by motor manifestations, autonomic and neurological disorders and sensorial symptoms. Medication therapy management (MTM) consists of a service undertaken by pharmacists to optimize pharmacological therapy results. This way, the pharmacist monitors the treatment prescribed by the doctor and formulates a healthcare plan to guarantee the treatment’s effectiveness, safety and convenience, thereby improving the patient’s quality of life (QoL). Objective To analyze the effect of MTM upon medicine-related problems, motor symptoms, autonomic disorders and QoL of patients with Parkinson’s disease, and describe the pharmaceutical interventions. Methods Quasi-experimental uncontrolled before-and-after study carried out between September 2012 and March 2013 in a community pharmacy. Pharmacotherapy data were collected from medical prescriptions, patient diaries, medical charts and all the medicines (over-the-counter and prescription) brought by the patients to the appointment with the pharmacist. The medicine-related problems were classified as indication, effectiveness, safety and adherence. Adherence was measured through clinical interviews and the Morisky questionnaire. PD symptoms were assessed according to the patients’ and/or caregivers’ perceptions about the On/Off state of the motor symptoms and relief of the nonmotor symptoms. QoL was assessed using the PDQ-39 scores. The interventions were targeted to patients/caregivers and/or doctors, with pharmacological and non-pharmacological measures. Results Seventy patients were followed up, showing a decrease in medicine-related problems (1.67 ± 1.34 to 0.8 ± 0.9 (p < 0.001), positive impact on adherence (from 37 to 10 non-adherent patients, p < 0.001), QoL improvement related to emotional wellbeing (p = 0.012) and autonomic disorder. Most interventions were performed directly with the patients (73.8%), including non-pharmacological guidance (28.5%), pharmacological guidance (24.3%) and rescheduling (13.6%). Conclusions To carry out MTM with PD patients, the pharmacist’s expertise needs to transcend the technical knowledge about the PD pharmacological treatment. The study showed a positive effect with a decrease in the medicine-related problems after the interventions, especially improving adherence and patients’ QoL.
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Affiliation(s)
- Aline Aparecida Foppa
- Farmácia Escola UFSC/PMF, Post-Graduate Program in Pharmaceutical Assistance, UFSC, Florianópolis, SC, Brazil.
| | - Clarice Chemello
- Department of Social Pharmacy, Faculty of Pharmacy, UFMG, Belo Horizonte, MG, Brazil
| | | | - Mareni Rocha Farias
- Department of Pharmaceutical Sciences, Health and Science Center, UFSC, Florianópolis, SC, Brazil
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Impact of Sex on the Nonmotor Symptoms and the Health-Related Quality of Life in Parkinson's Disease. PARKINSONS DISEASE 2016; 2016:7951840. [PMID: 27293959 PMCID: PMC4884810 DOI: 10.1155/2016/7951840] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/27/2016] [Accepted: 04/12/2016] [Indexed: 12/30/2022]
Abstract
Background. Female Parkinson's disease (PD) patients seem to experience not only more severe motor complications and postural instability but also more pronounced depression, anxiety, pain, and sleep disturbances. Objective. The aim of the present study was to evaluate the role of sex as a possible independent predictor of HRQoL in PD. Methods. In this cross-sectional study, 621 consecutive patients treated at the University of Pécs were enrolled. Severity of PD symptoms was assessed by MDS-UPDRS, UDysRS, Non-Motor Symptoms Scale, PDSS-2, Hamilton Anxiety Scale, Montgomery-Asberg Depression Rating Scale, Lille Apathy Rating Scale, and Addenbrooke Cognitive Examination. HRQoL was assessed by PDQ-39 and EQ-5D. Multiple regression analysis was performed to estimate the PDQ-39 and EQ-5D index values based on various clinical factors. Results. Although females received significantly lower dosage of levodopa, they had significantly more disabling dyskinesia and worse postural instability. Anxiety, pain, sleep disturbances, and orthostatic symptoms were more frequent among females while sexual dysfunction, apathy, and daytime sleepiness were more severe among males. Women had worse HRQoL than men (EQ-5D index value: 0.620 ± 0.240 versus 0.663 ± 0.229, p = 0.025, and PDQ-39 SI: 27.1 ± 17.0 versus 23.5 ± 15.9, p = 0.010). Based on multiple regression analysis, sex was an independent predictor for HRQoL in PD. Conclusions. Based on our results, female sex is an independent predictor for having worse HRQoL in PD.
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van Uem JM, Isaacs T, Lewin A, Bresolin E, Salkovic D, Espay AJ, Matthews H, Maetzler W. A Viewpoint on Wearable Technology-Enabled Measurement of Wellbeing and Health-Related Quality of Life in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2016; 6:279-87. [PMID: 27003779 PMCID: PMC4927928 DOI: 10.3233/jpd-150740] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 02/06/2023]
Abstract
In this viewpoint, we discuss how several aspects of Parkinson's disease (PD) - known to be correlated with wellbeing and health-related quality of life-could be measured using wearable devices ('wearables'). Moreover, three people with PD (PwP) having exhaustive experience with using such devices write about their personal understanding of wellbeing and health-related quality of life, building a bridge between the true needs defined by PwP and the available methods of data collection. Rapidly evolving new technologies develop wearables that probe function and behaviour in domestic environments of people with chronic conditions such as PD and have the potential to serve their needs. Gathered data can serve to inform patient-driven management changes, enabling greater control by PwP and enhancing likelihood of improvements in wellbeing and health-related quality of life. Data can also be used to quantify wellbeing and health-related quality of life. Additionally these techniques can uncover novel more sensitive and more ecologically valid disease-related endpoints. Active involvement of PwP in data collection and interpretation stands to provide personally and clinically meaningful endpoints and milestones to inform advances in research and relevance of translational efforts in PD.
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Affiliation(s)
- Janet M.T. van Uem
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | | | | | | | - Dina Salkovic
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Alberto J. Espay
- Gardner Center for Parkinson’s disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA
| | | | - Walter Maetzler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
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Quality of life in patients with PD and their caregiving spouses: A view from both sides. Clin Neurol Neurosurg 2015; 139:24-8. [DOI: 10.1016/j.clineuro.2015.08.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 04/01/2015] [Accepted: 08/22/2015] [Indexed: 11/19/2022]
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Richter VC, Coelho M, Arantes EDC, Dessotte CAM, Schmidt A, Dantas RAS, Rossi LA, Furuya RK. Health status and mental health in patients after percutaneous coronary intervention. Rev Bras Enferm 2015; 68:589-95, 676-82. [PMID: 26422040 DOI: 10.1590/0034-7167.2015680415i] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to assess the association between perceived health status and the mental health of patients submitted to percutaneous coronary intervention after hospital discharge. METHOD a quantitative and cross-sectional study involving 101 participants. The following instruments were used: a sociodemographic and clinical characterization instrument, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). Participants were divided into three groups: no anxiety and no depression (G1); anxiety or depression (G2); and both (G3). The ANOVA test was used for the intergroup comparison of means on the SF-36 domains. RESULTS There was an association between perceived health status and mental health. The participants in G1 presented higher scores in all SF-36 domains in comparison with participants in G2 and G3. CONCLUSION Participants with no anxiety and depression presented better-perceived health status in comparison with those with anxiety or depression, or both.
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Affiliation(s)
- Vitor Cesar Richter
- Curso de Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Mariana Coelho
- Curso de Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Eliana de Cássia Arantes
- Programa de Pós-Graduação em Enfermagem Fundamental, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Carina Aparecida Marosti Dessotte
- Departamento de Enfermagem Geral e Especializada, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - André Schmidt
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Rosana Aparecida Spadoti Dantas
- Departamento de Enfermagem Geral e Especializada, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Lídia Aparecida Rossi
- Departamento de Enfermagem Geral e Especializada, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Rejane Kiyomi Furuya
- Programa de Pós-Graduação Interunidades de Doutoramento em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
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Kadastik-Eerme L, Rosenthal M, Paju T, Muldmaa M, Taba P. Health-related quality of life in Parkinson's disease: a cross-sectional study focusing on non-motor symptoms. Health Qual Life Outcomes 2015; 13:83. [PMID: 26088201 PMCID: PMC4474578 DOI: 10.1186/s12955-015-0281-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 06/06/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate factors affecting health-related quality of life (HRQoL) among Estonian persons with Parkinson's disease (PD). METHODS 268 persons with PD were evaluated using: the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr scale (HY); the Schwab and England Activities of Daily Living scale (SE-ADL); the Beck Depression Inventory (BDI); the Mini Mental State Examination (MMSE); the Parkinson's Disease Questionnaire (PDQ-39). Additional questions on clinical and socio-demographic variables were asked during a semi-structured interview. Predictors of HRQoL were tested using multiple regression analysis. RESULTS The main predictors of low HRQoL were depression and motor and non-motor aspects of daily living. 59.9 % of the variation in the PDQ-39 summary index (SI) score was explained by the predictive variables identified in this study. None of the socio-demographic variables (age, gender, urban/rural living, marital status, living alone/with others, education level) were significant predictors of HRQoL. Prevalence of non-motor Parkinson's symptoms were high (99.6 %); cognitive impairment, sleep and urinary problems were the most common. All non-motor symptoms correlated significantly with low HRQoL, except the features of impulse control disorders (ICDs). CONCLUSIONS Depression and motor and non-motor daily living experiences were found to be significant and independent factors of low HRQoL in persons with PD. Depression was the strongest determinant of low HRQoL. Our results highlight the importance of recognition and management of non-motor symptoms, as these features had more impact on patients' HRQoL than clinically assessed motor symptoms.
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Affiliation(s)
- Liis Kadastik-Eerme
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
| | - Marika Rosenthal
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
| | - Tiiu Paju
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
| | - Mari Muldmaa
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
| | - Pille Taba
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
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Campos LS, Guimarães RP, Piovesana LG, Azevedo PCD, Santos LMB, D’Abreu A. Clinical predictors of cognitive impairment and psychiatric complications in Parkinson’s disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:390-5. [DOI: 10.1590/0004-282x20150016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 12/30/2014] [Indexed: 11/22/2022]
Abstract
Objective To estimate the clinical and demographics aspects that may contribute to cognitive impairment and psychiatric symptoms in Parkinson’s disease (PD). Method All patients answered a structured standardized clinical questionnaire. Two movement disorders specialists performed the following scale: Unified Parkinson’s disease rating score (UPDRS), the modified Hoehn and Yahr staging, Schwab and England Scale, SCOPA cognition (SCOPA-COG), SCOPA-Psychiatric complications (SCOPA-PC) and Non-Motor Symptoms Scale (NMSS). We built a generalized linear model to assess predictors for the SCOPA-COG and SCOPA-PC scores. Results Almost 37% of our patients were demented as per SCOPA-COG scores. Level of education and the UPDRS-Subscale III were predictors of cognitive impairment. Higher scores in domain 3 of NMSS and male gender were associated with psychiatric complications as assessed per the SCOPA-PC. Conclusion Level of education and disease severity are predictors of dementia in PD. Psychiatric complications are more commonly observed in men.
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Luo XF, Zhang BL, Li JC, Yang YY, Sun YF, Zhao H. Lateral habenula as a link between dopaminergic and serotonergic systems contributes to depressive symptoms in Parkinson's disease. Brain Res Bull 2014; 110:40-6. [PMID: 25499570 DOI: 10.1016/j.brainresbull.2014.11.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 11/26/2014] [Accepted: 11/29/2014] [Indexed: 01/09/2023]
Abstract
Degeneration of substantia nigra dopaminergic neurons is a key pathological change of Parkinson's disease (PD), and its motor consequences have been widely recognized. Recently, mood disorders associated with PD have begun to attract a great deal of interest, however, their pathogenesis remains unclear. PD is associated with not only degenerative changes in dopaminergic neurons in the substantia nigra but also changes in serotonergic neurons in the raphe nuclei. The abnormalities in central 5-hydroxytryptamine (5-HT) neurotransmission are thought to play a key role in the pathogenesis of depression. The lateral habenula (LHb) is closely related to the substantia nigra and raphe nuclei, and its hyperactivity is closely related to the pathogenesis of depression. In this study, we screened rats with depressive-like behaviors from PD model animals and found that cytochrome c oxidase activity in the LHb of these rats was twice that seen in the control rats. In the forced swim test, LHb lesions caused a decrease in depressive-like behavior of PD rats as indexed by decreased immobility times and increased climbing times. Additionally, LHb lesions caused an enhance in 5-HT levels in the raphe nuclei. These results suggest that LHb lesions may improve depressive-like behavior in PD rats by increasing 5-HT levels in the raphe nuclei. Thus, LHb contributes to the depressive-like behavior in PD rats via mediating the effects of dopaminergic neurons in the substantia nigra on serotonergic neurons in the raphe nuclei.
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Affiliation(s)
- Xiao Feng Luo
- Department of Physiology, Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China
| | - Bei Lin Zhang
- Department of Physiology, Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China
| | - Ji Cheng Li
- Department of Physiology, Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China
| | - Ying Ying Yang
- Department of Physiology, Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China
| | - Yan Fei Sun
- Department of Physiology, Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China
| | - Hua Zhao
- Department of Physiology, Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun 130021, PR China.
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Lawrence BJ, Gasson N, Kane R, Bucks RS, Loftus AM. Activities of daily living, depression, and quality of life in Parkinson's disease. PLoS One 2014; 9:e102294. [PMID: 25025280 PMCID: PMC4099301 DOI: 10.1371/journal.pone.0102294] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/17/2014] [Indexed: 12/13/2022] Open
Abstract
This study examined whether activities of daily living (ADL) mediate the relationship between depression and health-related quality of life (HR-QOL) in people with Parkinson's disease (PD). A cross-sectional, correlational research design examined data from 174 participants who completed the Geriatric Depression Scale (GDS-15), Parkinson's Disease Questionnaire-39 (PDQ-39), and Unified Parkinson's Disease Rating Scale-section 2 (UPDRS-section 2 [ADL]). Multiple Regression Analysis (MRA) was used to examine the mediator model. Depression and ADL significantly (p<.001) predicted HR-QOL, and depression significantly (p<.001) predicted ADL. Whilst ADL did not impact on the relationship between depression and HR-QOL, there was a significant (p<.001) indirect effect of depression on HR-QOL via ADL, suggesting both direct and indirect (via ADL) effects of depression on HR-QOL. The magnitude of this effect was moderate (R2 = .13). People with PD who report depression also experience greater difficulty completing ADL, which impacts upon their HR-QOL. It is recommended that clinicians adopt a multidisciplinary approach to care by combining pharmacological treatments with psycho/occupational therapy, thereby alleviating the heterogeneous impact of motor and non-motor symptoms on HR-QOL in people with PD.
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Affiliation(s)
- Blake J. Lawrence
- Curtin Neuroscience Laboratory, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
- * E-mail:
| | - Natalie Gasson
- Curtin Neuroscience Laboratory, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
- Parkinson's Centre (ParkC), Curtin University, Perth, Western Australia, Australia
| | - Robert Kane
- Curtin Neuroscience Laboratory, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Romola S. Bucks
- Parkinson's Centre (ParkC), Curtin University, Perth, Western Australia, Australia
- School of Psychology, University of Western Australia, Perth, Western Australia, Australia
| | - Andrea M. Loftus
- Curtin Neuroscience Laboratory, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
- Parkinson's Centre (ParkC), Curtin University, Perth, Western Australia, Australia
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Chemello C, Souza FD, Patricio EDS, Farias MR. Pharmaceutical care as a strategy to improve the safety and effectiveness of patients? pharmacotherapy at a pharmacy school: a practical proposal. BRAZ J PHARM SCI 2014. [DOI: 10.1590/s1984-82502011000100019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Several patients experience at least one drug-related problem and Pharmaceutical Care can change this reality. This work describes a model for structuring the pharmaceutical care service at a pharmacy training unit of the Brazilian Public Health System based on pharmacotherapy follow-up program of Parkinson’s disease patients’ results. From the follow-up results (phase 1), a Therapy Management Scheme was designed (phase 2). Of the 57 patients followed-up, 30 presented at least one drug-related problem and 42% were non-adherent to treatment, which supported the need of pharmacotherapy management. The Pharmacotherapy Management Scheme was proposed as a pharmaceutical care service model, which presents 6 steps: first, the pharmacist fills out the dispensing form and assesses patient´s pharmacotherapy, if there is a suspect problem, he is invited to the follow-up (steps 1 and 2) and they agree the first appointment. After that, pharmacist studies the patient’s case (study phase, steps 3 and 4). At the second meeting, the pharmacist proposes the intervention needed, and at the third, assesses the intervention results and new problems (steps 5 and 6, respectively). The process ends when all therapeutics outcomes are reached. This practical model can significantly contributed to the development and organization of pharmaceutical care services.
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Martinez-Martin P, Rodriguez-Blazquez C, Frades-Payo B. Specific patient-reported outcome measures for Parkinson’s disease: analysis and applications. Expert Rev Pharmacoecon Outcomes Res 2014; 8:401-18. [DOI: 10.1586/14737167.8.4.401] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Soh SE, McGinley JL, Watts JJ, Iansek R, Morris ME. Health-related quality of life of australians with Parkinson disease: a comparison with international studies. Physiother Can 2013; 64:338-46. [PMID: 23997388 DOI: 10.3138/ptc.2011-26] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE This study describes the health-related quality of life (HRQOL) of Australians living with Parkinson disease (PD) and compares the findings to international reports. METHODS The Parkinson's Disease Questionnaire-39 (PDQ-39) was used to measure HRQOL in 210 individuals with PD living in Australia. In parallel, a tailored literature search identified previous studies on HROQL in people with PD. A quantitative meta-analysis with a random-effects model was used to compare the HRQOL of individuals with PD living in Australia and other countries. RESULTS The mean PDQ-39 summary index (SI) score for this sample of Australians with PD was 20.9 (SD 12.7). Ratings for the dimension of social support and stigma were significantly lower than ratings for bodily discomfort, mobility, activities of daily living, cognition, and emotional well-being. Comparing the Australian and international PD samples revealed a significant heterogeneity in overall HRQOL (I(2)=97%). The mean PDQ-39 SI scores for Australians were lower, indicating better HRQOL relative to samples from other countries. CONCLUSIONS This Australian sample with PD perceived their HRQOL as poor, although it was less severely compromised than that of international samples. While further research is required, these findings can inform the clinical decision-making processes of physiotherapists.
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Affiliation(s)
- Sze-Ee Soh
- Physiotherapy Department, Alfred Health ; Physiotherapy Department, Melbourne School of Health Sciences, University of Melbourne
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Rodríguez-Violante M, Cervantes-Arriaga A, Corona T, Martínez-Ramírez D, Morales-Briceño H, Martínez-Martín P. Clinical determinants of health-related quality of life in Mexican patients with Parkinson's disease. Arch Med Res 2013; 44:110-4. [PMID: 23376054 DOI: 10.1016/j.arcmed.2013.01.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 01/17/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS Parkinson's disease (PD) is the second most common chronic neurodegenerative disorder. PD is clinically characterized by a constellation of motor and nonmotor symptoms that may have a direct effect on daily activities as well as in the quality of life of the patient. Identifying the symptoms more closely associated with a poor quality of life is central on improving the medical care of the patient. We undertook this study to identify and describe the clinical and demographic factors that predict health-related quality of life among Mexican patients with PD. METHODS One hundred seventy-seven patients with Parkinson's disease were included. Patients were evaluated using the following clinimetric instruments: motor subscale of the Unified Parkinson's disease rating scale, Hoehn and Yahr stage, Non-motor Symptoms Questionnaire, Parkinson's disease Questionnaire (PDQ-39) and the Mini Mental Status Examination. RESULTS Multivariate analysis showed that the main factors associated with a poor quality of life were motor impairment (β = 0.27, p <0.001) and the number of nonmotor symptoms (β = 2.17, p <0.001). The main nonmotor domains impacting on the quality of life were depression/anxiety (β = 6.36, p <0.001), cardiovascular (β = 5.39, p = 0.001), memory (β = 4.64, p <0.001) and miscellaneous (β = 3.15, p = 0.001). CONCLUSIONS Both motor and mainly nonmotor symptoms are negatively associated with health-related quality of life in patients with PD and should be appropriately attended in order to improve patient care.
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Carod-Artal FJ. Determining quality of life in stroke survivors. Expert Rev Pharmacoecon Outcomes Res 2012; 12:199-211. [PMID: 22458621 DOI: 10.1586/erp.11.104] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Post-stroke health-related quality of life (HRQoL) reflects a comprehensive view of subjective health and a measure of a person's perceived physical, mental and social health following stroke. Generic scales may enable comparisons between groups of patients with a diverse range of conditions, although they may underestimate the effect of stroke owing to its limited content validity. Stroke-specific HRQoL measures were designed to assess relevant domains that are important to stroke patients. The Stroke Impact Scale, the Stroke Specific Quality of Life scale and The Burden of Stroke Scale are specific HRQoL instruments developed in the last decade. Demographic factors, comorbidity, stroke severity, disability and psychosocial factors (e.g., post-stroke depression and social support) are significant predictors of HRQoL in stroke survivors. Stroke caregiver burden and HRQoL are inversely correlated. HRQoL measures are increasingly used to evaluate the effect of some therapeutic interventions in stroke survivors.
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Neurologists' diagnostic accuracy of depression and cognitive problems in patients with parkinsonism. BMC Neurol 2012; 12:37. [PMID: 22702891 PMCID: PMC3465198 DOI: 10.1186/1471-2377-12-37] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 05/18/2012] [Indexed: 12/18/2022] Open
Abstract
Background Depression and cognitive impairment (CI) are important non-motor symptoms in Parkinson’s Disease (PD) and related syndromes, but it is not clear how well they are recognised in daily practice. We have studied the diagnostic performance of experienced neurologists on the topics depression and cognitive impairment during a routine encounter with a patient with recent-onset parkinsonian symptoms. Methods Two experienced neurologists took the history and examined 104 patients with a recent-onset parkinsonian disorder, and assessed the presence of depression and cognitive impairment. On the same day, all patients underwent a Hamilton Depression Rating Scale test, and a Scales for Outcomes in Parkinson’s Disease-Cognition-test (SCOPA-COG). Results The sensitivity of the neurologists for the topic depression was poor: 33.3%. However, the specificity varied from 90.8 to 94.7%. The patients’ sensitivity was higher, although the specificity was lower. On the topic CI, the sensitivity of the neurologists was again low, in a range from 30.4 up to 34.8%: however the specificity was high, with 92.9%. The patients’ sensitivity and specificity were both lower, compared to the number of the neurologists. Conclusions Neurologists’ intuition and clinical judgment alone are not accurate for detection of depression or cognitive impairment in patients with recent-onset parkinsonian symptoms because of low sensitivity despite of high specificity. Trial registration (ITRSCC)NCT0036819.
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Gender-related differences in the burden of non-motor symptoms in Parkinson's disease. J Neurol 2012; 259:1639-47. [PMID: 22237822 DOI: 10.1007/s00415-011-6392-3] [Citation(s) in RCA: 182] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 12/20/2011] [Accepted: 12/21/2011] [Indexed: 01/24/2023]
Abstract
Differences in the expression of non-motor symptoms (NMS) by Parkinson's disease (PD) patients may have important implications for their management and prognosis. Gender is a basic epidemiological variable that could influence such expression. The present study evaluated the prevalence and severity of NMS by gender in an international sample of 951 PD patients, 62.63% males, using the non-motor symptoms scale (NMSS). Assessments for motor impairment and complications, global severity, and health state were also applied. All disease stages were included. No significant gender differences were found for demographic and clinical characteristics. For the entire sample, the most prevalent symptoms were Nocturia (64.88%) and Fatigue (62.78%) and the most prevalent affected domains were Sleep/Fatigue (84.02%) and Miscellaneous (82.44%). Fatigue, feelings of nervousness, feelings of sadness, constipation, restless legs, and pain were more common and severe in women. On the contrary, daytime sleepiness, dribbling saliva, interest in sex, and problems having sex were more prevalent and severe in men. Regarding the NMSS domains, Mood/Apathy and Miscellaneous problems (pain, loss of taste or smell, weight change, and excessive sweating) were predominantly affected in women and Sexual dysfunction in men. No other significant differences by gender were observed. To conclude, in this study significant differences between men and women in prevalence and severity of fatigue, mood, sexual and digestive problems, pain, restless legs, and daytime sleepiness were found. Gender-related patterns of NMS involvement may be relevant for clinical trials in PD.
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Zahodne LB, Marsiske M, Okun MS, Rodriguez RL, Malaty I, Bowers D. Mood and motor trajectories in Parkinson's disease: multivariate latent growth curve modeling. Neuropsychology 2012; 26:71-80. [PMID: 22142359 PMCID: PMC3296901 DOI: 10.1037/a0025119] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Apathy is a common feature of Parkinson's disease (PD) that can manifest independently of depression, but little is known about its natural progression in medically managed patients. The present study sought to characterize and compare trajectories of apathy, depression, and motor symptoms in PD over 18 months. METHOD Data from a sample of 186 PD patients (mean disease duration of 8.2 years) followed by the University of Florida Movement Disorders Center were obtained from a clinical research database. Scores on the Unified Parkinson's disease Rating Scale (motor portion), Apathy Scale, and Beck Depression Inventory at three time-points (baseline, 6 months, 18 months) were analyzed in a structural equation modeling framework. RESULTS A multivariate growth model controlling for age, sex, education, and disease duration identified linear worsening of both apathy (slope estimate = 0.73; p < .001) and motor symptoms (slope estimate = 1.51; p < .001), and quadratic changes in depression (slope estimate = 1.18; p = .07). All symptoms were positively correlated. Higher education was associated with lower apathy, depression, and motor severity. Advanced age was associated with greater motor and apathy severity. Female sex and longer disease duration were associated with attenuated motor worsening. Antidepressant use was associated only with depression scores. CONCLUSIONS These longitudinal results support the differentiation of apathy and depression in PD. Like motor progression, apathy progression may be linked at least partially to dopaminergic neurodegeneration. Empirically supported treatments for apathy in PD are needed.
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Affiliation(s)
- Laura B Zahodne
- Department of Clinical and Health Psychology, University of Florida, P. O. Box 100165, Gainesville, FL 32610-0165, USA.
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The importance of non-motor disturbances to quality of life in Parkinson's disease. J Neurol Sci 2011; 310:12-6. [DOI: 10.1016/j.jns.2011.05.006] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 05/07/2011] [Indexed: 11/20/2022]
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Andreadou E, Anagnostouli M, Vasdekis V, Kararizou E, Rentzos M, Kontaxis T, Evdokimidis I. The impact of comorbidity and other clinical and sociodemographic factors on health-related quality of life in Greek patients with Parkinson's disease. Aging Ment Health 2011; 15:913-21. [PMID: 21547746 DOI: 10.1080/13607863.2011.569477] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES This study was designed to evaluate the impact of other common self-reported comorbid disorders (hypertension, dyslipidemia, ischemic heart disease, diabetes mellitus, minor stroke, arthritis, low back pain or osteoporosis and depression) on health-related Quality of Life (HRQoL) of Parkinson's disease (PD) patients and to explore the association of their HRQoL with various sociodemographic and clinical factors. METHODS Data about age, gender, education, occupation, income, marital and residential status, social relations, disease duration, functional status, treatment and concomitant diseases were collected of 139 Greek patients (68 men and 71 women) with PD. Patients were consecutively recruited from the outpatient clinic of the first Neurology Department of Athens National University at Aeginition Hospital. Disease severity was assessed using the unified Parkinson's disease rating scale including Hoehn and Yahr and Schwab and England (S&E) scales. HRQoL was measured by the specific Parkinson's disease questionnaire (PDQ-39). A multivariate multiple regression model with normal errors was used for the statistical analysis. RESULTS The main determinants of HRQoL were low degree of independence measured by the S&E scale (F = 35.942, p < 0.001), social isolation (F = 20.508, p < 0.001), disease duration (F = 14.983, p < 0.001), sleep (F = 6.507, p = 0.013) and gastrointestinal disturbances (F = 4.643, p = 0.035) and the presence of depression (F = 6.022, p = 0.017). CONCLUSION Among the other chronic comorbidities only depression was associated with a poor HRQoL in PD patients. Functional dependence and social isolation contributed most to worse HRQoL. Our findings suggest that adequate social support and management of depression, sleep and gastrointestinal disturbances could reduce the distress and improve HRQoL in patients with PD.
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Affiliation(s)
- Elisabeth Andreadou
- 1st Department of Neurology, Medical School, Athens National and Kapodistrian University, 'Aeginition' Hospital, Greece.
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Winter Y, Spottke AE, Stamelou M, Cabanel N, Eggert K, Höglinger GU, Sixel-Doering F, Herting B, Klockgether T, Reichmann H, Oertel WH, Dodel R. Health-related quality of life in multiple system atrophy and progressive supranuclear palsy. NEURODEGENER DIS 2011; 8:438-46. [PMID: 21576919 DOI: 10.1159/000325829] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 02/16/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Multiple system atrophy (MSA) and progressive supranuclear palsy (PSP), known as atypical parkinsonian syndromes (APS), are neurodegenerative disorders with severe disability and decreased life expectancy. Little is known about the health-related quality of life (HrQoL) and its determinants in patients with those disorders. The objective of our cross-sectional study was to evaluate the HrQoL in patients with APS and to identify the determinants of HrQoL. METHODS A total of 101 consecutive patients with MSA (n = 54) and PSP (n = 47) were recruited in four German neurological centers. Disease severity was assessed using the Hoehn and Yahr stages and the Unified MSA Rating Scale. The HrQoL was evaluated using the EuroQol instrument (EQ-5D and EQ-VAS). Independent determinants of HrQoL were identified in multiple regression analyses. RESULTS The mean EQ-VAS score was 52% lower than that reported for the general population (36.9 ± 18.3 vs. 77.4 ± 19.0). Of the study participants, 63% reported severe problems in at least one dimension of the EQ-5D. Cerebellar dysfunction was associated with a more considerable reduction of HrQoL. Independent determinants of reduced HrQoL were female gender, <12 years of education, disease severity, a decreased number of persons in the household and depression. CONCLUSIONS The HrQoL in MSA and PSP is considerably reduced. While therapeutic options in the treatment of motor symptoms remain restricted, greater attention should be paid to the treatment of depression, which was identified among independent determinants of HrQoL. Independent determinants of HrQoL should be considered when developing healthcare programs aimed at improving the HrQoL in APS.
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Affiliation(s)
- Yaroslav Winter
- Department of Neurology, Philipps University Marburg, Marburg, Germany
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Lorenz D, Poremba C, Papengut F, Schreiber S, Deuschl G. The psychosocial burden of essential tremor in an outpatient- and a community-based cohort. Eur J Neurol 2011; 18:972-9. [PMID: 21244579 DOI: 10.1111/j.1468-1331.2010.03295.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE To compare psychosocial burden in patients with essential tremor (ET) in an outpatient (OPC)- and a community-based cohort (CBC). METHODS A sample of outpatients of a tertiary referral center (n = 180) and a community-based sample (n = 100) with ET were asked for study participation. Psychosocial aspects were assessed by a questionnaire on psychosocial aspects of ET, neuropsychological scales, quality of life, personality traits, and coping strategies. RESULTS One hundred and seven patients of the OPC and 90 individuals of the CBC participated and their results are descriptively presented. Statistical analysis was restricted to 38 pairs of OPC and CBC individuals matched for age, sex, and tremor severity. One-third of these individuals reported a profound impairment in everyday or professional life. Neuropsychological scales showed a severe depression in 8% of the individuals and pathologic values for the general level of psychiatric symptoms in 26%. The main coping strategy was 'active problem-orientated coping'. Patients of the OPC perceived a more severe impact of ET on their life. Multivariate analysis revealed the Beck Depression Inventory score as the only predictive factor for the outcome variables, physical and mental component scores, of the SF-12 health survey. CONCLUSIONS ET causes a significant psychosocial impairment, which does depend on symptom severity but also on mood with depression as the main driving factor and other so far undetermined factors.
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Affiliation(s)
- D Lorenz
- Department of Neurology Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Gallagher DA, Lees AJ, Schrag A. What are the most important nonmotor symptoms in patients with Parkinson's disease and are we missing them? Mov Disord 2010; 25:2493-500. [DOI: 10.1002/mds.23394] [Citation(s) in RCA: 334] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Determinants of health-related quality of life in Parkinson's disease: a systematic review. Parkinsonism Relat Disord 2010; 17:1-9. [PMID: 20833572 DOI: 10.1016/j.parkreldis.2010.08.012] [Citation(s) in RCA: 256] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 08/12/2010] [Accepted: 08/13/2010] [Indexed: 11/22/2022]
Abstract
This systematic review critically evaluates the literature to identify the demographic and clinical factors that predict the health-related quality of life (HRQOL) of people with Parkinson's disease (PD). Understanding how these factors relate to HRQOL in people with PD may assist clinicians minimise the functional and social impact of the disease by optimising their assessment and clinical decision making processes. A tailored search strategy in six databases identified 29 full-text reports that fulfilled the pre-defined inclusion and exclusion criteria. The quality of included studies was assessed by two independent reviewers using a customized assessment form. A best-evidence synthesis was used to summarise the demographic and clinical factors that were examined in relation to HRQOL. Depression was the most frequently identified determinant of HRQOL in people with idiopathic PD. Disease severity and disease disability were also found to be predictive of poor HRQOL outcomes in many studies. The motor symptoms that contributed most often to overall life quality were gait impairments and complications arising from medication therapy. To minimise the impact of PD on HRQOL, it may be necessary to consider the extent to which demographic factors and motor and non-motor symptoms contribute to life quality.
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Kleiner-Fisman G, Stern MB, Fisman DN. Health-related quality of life in Parkinson disease: correlation between Health Utilities Index III and Unified Parkinson's Disease Rating Scale (UPDRS) in U.S. male veterans. Health Qual Life Outcomes 2010; 8:91. [PMID: 20799993 PMCID: PMC2939643 DOI: 10.1186/1477-7525-8-91] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Accepted: 08/30/2010] [Indexed: 01/11/2023] Open
Abstract
Objective To apply a scaled, preference-based measure to the evaluation of health-related quality of life (HRQoL) in Parkinson's disease (PD); to evaluate the relationship between disease-specific rating scales and estimated HRQoL; and to identify predictors of diminished HRQoL. Background Scaled, preference-based measures of HRQoL ("utilities") serve as indices of impact of disease, and can be used to generate quality-adjusted estimates of survival for health-economic evaluations. Evaluation of utilities for PD and their correlation with standard rating scales have been limited. Methods Utilities were generated using the Health Utilities Index Mark III (HUI-III) on consecutive patients attending a PD Clinic between October 2003 and June 2006. Disease severity, medical, surgical (subthalamic nucleus deep brain stimulation (STN-DBS)), and demographic information were used as model covariates. Predictors of HUI-III utility scores were evaluated using the Wilxocon rank-sum test and linear regression models. Results 68 men with a diagnosis of PD and a mean age of 74.0 (SD 7.4) were included in the data analysis. Mean HUI-III utility at first visit was 0.45 (SD 0.33). In multivariable models, UPDRS-II score (r2 = 0.56, P < 0.001) was highly predictive of HRQoL. UPDRS-III was a weaker, but still significant, predictor of utility scores, even after adjustment for UPDRS-II (P = 0.01). Conclusions Poor self-care in PD reflected by worsening UPDRS-II scores is strongly correlated with low generic HRQoL. HUI-III-based health utilities display convergent validity with the UPDRS-II. These findings highlight the importance of measures of independence as determinants of HRQoL in PD, and will facilitate the utilization of existing UPDRS data into economic analyses of PD therapies.
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Social and clinical determinants of quality of life in Parkinson's disease in a Russian cohort study. Parkinsonism Relat Disord 2010; 16:243-8. [DOI: 10.1016/j.parkreldis.2009.11.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 11/05/2009] [Accepted: 11/26/2009] [Indexed: 11/19/2022]
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Tedrus GMAS, Fonseca LC, Kange PM. Parkinson's disease: Impact of clinical and cognitive aspects on quality of life. Dement Neuropsychol 2010; 4:131-137. [PMID: 29213676 PMCID: PMC5619172 DOI: 10.1590/s1980-57642010dn40200010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2009] [Accepted: 04/14/2010] [Indexed: 11/26/2022] Open
Abstract
Parkinson's disease (PD) is a chronic disease manifested principally by motor signs and symptoms, but with frequent neuropsychological alterations. OBJECTIVES To study the relationship between clinical and cognitive aspects and the perception of quality of life (QOL) in PD patients. METHODS Twenty consecutive patients (13 men) with idiopathic PD (mean age: 64.5y), mean disease time of 7.8 years and at stages 1-3 according to the modified Hoehn and Yahr staging scale (HYS), all outpatients from the Neurology Department of the Celso Pierro General and Maternity Hospital (PUC-Campinas), were analyzed. The following were applied: a clinical-neurological assessment, the Mini-Mental State Examination (MMSE), standard neuropsychological battery of the CERAD (Consortium to Establish a Registry for Alzheimer's Disease), Hamilton Depression Rating Scale (HAM-D) and a QOL questionnaire (Parkinson's Disease Questionnaire - PDQ-39). Statistical analysis was carried out at a significance level of p<0.05. RESULTS On the PDQ-39 under the sections total, mobility and activities of daily living, and the items motor compromise (HYS) and language of the MMSE were predictors of worse QOL. Verbal fluency was a factor for emotional well-being on the PDQ-39, whereas higher scores for HAM-D and worse performance on the item attention and calculation of the MMSE were associated with worse QOL in the social support section. Total score on the MMSE and educational level were QOL factors in cognition. CONCLUSIONS The findings of the present study suggest that clinical, cognitive, motor or other depression-related factors contribute differently to the domains of QOL.
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Affiliation(s)
| | - Lineu Correa Fonseca
- Professor of Neurology, Pontifícia Universidade
Católica de Campinas, Campinas SP, Brazil (PUC-Campinas), Scholarship
holders
| | - Patrícia Mencaroni Kange
- Student of Faculty of Medicine with FAPIC placement
scholarship - Catholic University of Campinas (PUC-Campinas), Campinas SP,
Brazil
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Abstract
The purpose of this study was to investigate the prevalence and clinical correlates of apathy and depression in Parkinson disease (PD), and to clarify whether apathy can be dissociated from depression. One hundred fifty patients with PD completed the Beck Depression Inventory Second Edition (BDI-II), Starkstein's Apathy Scale (AS), and a quality of life (QOL) battery. Hoehn and Yahr (HY) staging, the Unified Parkinson's Disease Rating Scale (UPDRS), and the Mini-Mental State Examination (MMSE) were performed on the same day. Apathy (AS score > or = 16) was diagnosed in 60% of patients and depression (BDI-II score > or = 14) in 56%. Apathy coexisted with depression in 43% of patients, compared with depression without apathy in 13% and apathy without depression in 17%. Apathy scale score was significantly correlated with UPDRS scores, HY stage, and age, whereas BDI-II score was correlated only with UPDRS scores. Both AS and BDI-II scores were negatively correlated with QOL. However, multiple regression analysis revealed that depression was strongly and negatively associated with emotional well-being and communication, whereas apathy was mainly associated with cognition and stigma. These findings suggest that apathy and depression may be separable in PD, although both are common in patients with PD and are associated with QOL.
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Affiliation(s)
- Miyako Oguru
- Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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Winter Y, von Campenhausen S, Gasser J, Seppi K, Reese JP, Pfeiffer KP, Bötzel K, Oertel WH, Dodel R, Poewe W. Social and clinical determinants of quality of life in Parkinson's disease in Austria: a cohort study. J Neurol 2009; 257:638-45. [PMID: 19946784 DOI: 10.1007/s00415-009-5389-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 11/04/2009] [Accepted: 11/09/2009] [Indexed: 11/29/2022]
Abstract
Parkinson's disease (PD) is associated with a reduction of health-related quality of life (HrQoL). Demographic and clinical determinants of HrQoL in PD have been previously investigated, but less is known about its social determinants. Data on HrQoL in Austrian patients with PD are not available. The objective of this cross-sectional survey was to evaluate HrQoL of Austrian patients with PD and to provide a comprehensive analysis of its social and clinical determinants. Outpatients (n = 100) with idiopathic PD were recruited in the Department of Neurology of the University Innsbruck. Clinical status was estimated using the Unified Parkison's Disease Rating Scale (UPDRS). HrQoL was evaluated using a generic instrument, the EuroQol (EQ5D and EQ-VAS). Independent determinants of HrQoL were assessed in multivariate regression analysis. The proportion of PD patients with moderate or severe problems in at least one dimension of the EQ5D was significantly higher than in the general population (90.1 vs. 35.1%, P < 0.001). The mean EQ-VAS score in PD was lower than in the general population (48.9 +/- 19.6 vs. 77.0 +/- 20.8, P < 0.001). Social support (number of household members) was identified as an independent social determinant of HrQoL. Demographic and clinical determinants were age, depression, UPDRS and motor fluctuations. The analysis of determinants of HrQoL showed that a greater attention should be paid to social support and home care. Our data on HrQoL in PD should be considered in the development of new health care programs.
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Affiliation(s)
- Yaroslav Winter
- Department of Neurology, Philipps-University Marburg, Rudolf-Bultmannstr. 8, 35039, Marburg, Germany.
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Gómez-Esteban JC, Tijero B, Somme J, Bilbao I, Fernández J, Boyero S, Velasco F, Lezcano E, Zarranz JJ. Application of depression criteria (DSM-IV) in patients with Parkinson's disease. Clin Neurol Neurosurg 2009; 111:665-9. [PMID: 19589638 DOI: 10.1016/j.clineuro.2009.05.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2008] [Revised: 04/19/2009] [Accepted: 05/31/2009] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this study is to analyze the clinical differences between Parkinson's disease patients with major (MD) and minor depression (md) and to see how both affect the quality of life. MATERIAL AND METHODS 118 patients diagnosed with Parkinson's disease. The mean age of onset was 60.4+/-11.2 years with a mean duration of 8.5+/-6.2 years. Depression was diagnosed according to DSM-IV-TR criteria. Scores on the Hamilton depression inventory, MMSE, PDQ-39, NPI-10, UPDRS III, and UPDRS IV were recorded. RESULTS Twenty-one patients (17.8%) met the criteria of major depression (MD) and 33 (28.0%) those of minor depression (md). The scores on the PDQ-39 and NPI-10 of patients with MD were higher than in patients with md, and control group. The MMSE scores were lower in patients with MD. In 52.2% of the patients with MD, the diagnosis of depression was made prior to that of PD, this occurred only in 24.2% of the patients with md (p<0.001). The presence of anhedonia was related to cognitive impairment and the presence of neuropsychiatric symptoms. DISCUSSION MD is probably a part of the disease process of PD; it is associated with cognitive impairment and may precede motor symptoms.
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Affiliation(s)
- Juan Carlos Gómez-Esteban
- Movement Disorders Unit, Department of Neurology, Hospital of Cruces, Baracaldo Vizcaya, Osakidetza-Servicio Vasco de Salud, Spain.
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