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Chen Q, Scherbaum R, Gold R, Pitarokoili K, Mosig A, Zella S, Tönges L. Data-driven subtyping of Parkinson's disease: comparison of current methodologies and application to the Bochum PNS cohort. J Neural Transm (Vienna) 2023; 130:763-776. [PMID: 37000269 PMCID: PMC10199871 DOI: 10.1007/s00702-023-02627-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023]
Abstract
Considerable efforts have been made to better describe and identify Parkinson's disease (PD) subtypes. Cluster analyses have been proposed as an unbiased development approach for PD subtypes that could facilitate their identification, tracking of progression, and evaluation of therapeutic responses. A data-driven clustering analysis was applied to a PD cohort of 114 subjects enrolled at St. Josef-Hospital of the Ruhr University in Bochum (Germany). A wide spectrum of motor and non-motor scores including polyneuropathy-related measures was included into the analysis. K-means and hierarchical agglomerative clustering were performed to identify PD subtypes. Silhouette and Calinski-Harabasz Score Elbow were then employed as supporting evaluation metrics for determining the optimal number of clusters. Principal Component Analysis (PCA), analysis of variance (ANOVA), and analysis of covariance (ANCOVA) were conducted to determine the relevance of each score for the clusters' definition. Three PD cluster subtypes were identified: early onset mild type, intermediate type, and late-onset severe type. The between-cluster analysis consistently showed highly significant differences (P < 0.01), except for one of the scores measuring polyneuropathy (Neuropathy Disability Score; P = 0.609) and Levodopa dosage (P = 0.226). Parkinson's Disease Questionnaire (PDQ-39), Non-motor Symptom Questionnaire (NMSQuest), and the MDS-UPDRS Part II were found to be crucial factors for PD subtype differentiation. The present analysis identifies a specific set of criteria for PD subtyping based on an extensive panel of clinical and paraclinical scores. This analysis provides a foundation for further development of PD subtyping, including k-means and hierarchical agglomerative clustering.Trial registration: DRKS00020752, February 7, 2020, retrospectively registered.
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Affiliation(s)
- Qiang Chen
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44791, Bochum, Germany
| | - Raphael Scherbaum
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44791, Bochum, Germany
| | - Ralf Gold
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44791, Bochum, Germany
- Center for Protein Diagnostics (ProDi), Ruhr University Bochum, 44801, Bochum, Germany
- Immune-Mediated Neuropathies Biobank (INHIBIT), Ruhr-University Bochum, Bochum, Germany
| | - Kalliopi Pitarokoili
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44791, Bochum, Germany
- Immune-Mediated Neuropathies Biobank (INHIBIT), Ruhr-University Bochum, Bochum, Germany
| | - Axel Mosig
- Center for Protein Diagnostics (ProDi), Ruhr University Bochum, 44801, Bochum, Germany
- Bioinformatics Group, Ruhr University Bochum, 44801, Bochum, Germany
| | - Samis Zella
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44791, Bochum, Germany
- Department of Psychiatry, Landschaftsverband Rheinland-Klinik (LVR-Klinik), 40764, Langenfeld, Germany
- Medizinisches Zentrum für Erwachsene mit Behinderung (MZEB), Landschaftsverband Rheinland-Klinik, 40764, Langenfeld, Germany
| | - Lars Tönges
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44791, Bochum, Germany.
- Center for Protein Diagnostics (ProDi), Ruhr University Bochum, 44801, Bochum, Germany.
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D’Este G, Berra F, Carli G, Leitner C, Marelli S, Zucconi M, Casoni F, Ferini-Strambi L, Galbiati A. Cognitive Reserve in Isolated Rapid Eye-Movement Sleep Behavior Disorder. Brain Sci 2023; 13:brainsci13020176. [PMID: 36831719 PMCID: PMC9954116 DOI: 10.3390/brainsci13020176] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
Isolated rapid-eye-movement sleep behaviour disorder (RBD) is considered the prodromal stage of α-synucleinopathies (e.g., Parkinson's disease and dementia with Lewy bodies); however, iRBD patients show a wide variety in the progression timing (5-15 years). The model of cognitive reserve (CR) might contribute to explaining this phenomenon. Our exploratory study aimed to evaluate, for the first time, the impact of CR level on cognitive performance in polysomnography-confirmed iRBD patients. Fifty-five iRBD patients (mean age ± SD: 66.38 ± 7.51; M/F 44/11) underwent clinical and neuropsychological evaluations at the time of diagnosis. The CR Index questionnaire was part of the clinical assessment. We found that iRBD patients with high levels of CR showed: (i) the lowest percentage of mild cognitive impairment (10%), and (ii) the best performance in visuo-constructive and verbal memory functions (i.e., the recall of the Rey-Osterrieth complex figure test). Our results suggest that CR might help iRBD patients better cope with the cognitive decline related to the neurodegenerative process, providing the first preliminary findings supporting CR as a possible protective factor in this condition. This might pave the way for future longitudinal studies to evaluate the role of CR as a modulating factor in the timing of iRBD conversion and cognitive deterioration development.
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Affiliation(s)
- Giada D’Este
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesca Berra
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Giulia Carli
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Caterina Leitner
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Sara Marelli
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Marco Zucconi
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Francesca Casoni
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Luigi Ferini-Strambi
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Andrea Galbiati
- Department of Psychology, “Vita-Salute” San Raffaele University, 20132 Milan, Italy
- Sleep Disorders Center, Department of Clinical Neurosciences, Neurology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Correspondence: ; Tel.: +39-022-643-3397
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Severity of depressive and motor symptoms impacts quality of life in Parkinson's disease patients at an academic movement clinic: A cross-sectional study. Clin Park Relat Disord 2022; 8:100180. [PMID: 36590453 PMCID: PMC9795528 DOI: 10.1016/j.prdoa.2022.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Parkinson's disease (PD) is a neurodegenerative disease with motor and non-motor manifestations that have been previously reported to affect patient quality of life (QoL). Our objective is to investigate the factors that contribute to QoL in a cohort of PD patients receiving care at a major academic institution. Methods In this cross-sectional study of 124 participants (71.77% male, mean age 65.20, mean UPDRS-III score 11.25), we analyzed if certain clinical features such as UPDRS-III, QIDS-C, and total disease duration contributed to QoL as measured by two different metrics (PDQ-39 and EQ-5D) in PD patients at a university Movement Disorders Clinic. Results Motor symptoms of PD, with the exception of tremor, as well as depression and specific depressive symptoms were significantly and positively correlated with lower QoL metrics for patients with Parkinson's, with total depressive symptom severity (QIDS-C16 Total score) contributing most to QoL scores. Of the specific depressive and motor symptoms, anhedonia and rigidity contributed the most to QoL. Disease duration was significantly correlated with lower QoL for participants with Parkinson's according to the QoL metric PDQ-39 but not ED-5D. Parkinson's patients with access to high-quality healthcare are at risk for having diminished QoL due to both depressive and motor symptoms. Conclusion While severity of motor symptoms certainly impacted QoL in our cohort, our findings suggest that depressive symptoms contribute more to impaired QoL than severe motor symptoms do. This phenomenon suggests that concomitant depression in PD as well as one's psychological adjustment to disability may have a greater impact on QoL than severe motor symptoms.
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Sanchez-Luengos I, Lucas-Jiménez O, Ojeda N, Peña J, Gómez-Esteban JC, Gómez-Beldarrain MÁ, Vázquez-Picón R, Foncea-Beti N, Ibarretxe-Bilbao N. Predictors of health-related quality of life in Parkinson's disease: the impact of overlap between health-related quality of life and clinical measures. Qual Life Res 2022; 31:3241-3252. [PMID: 35842497 PMCID: PMC9546987 DOI: 10.1007/s11136-022-03187-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE This study aimed to determine predictors of health-related quality of life (HRQoL) in Parkinson's disease (PD) and to explore their predictive value before and after controlling overlapping items between HRQoL and clinical variables. METHODS One hundred and eight PD patients underwent motor, anxiety, depression, apathy, fatigue, and neurocognition assessment. HRQoL was assessed by the Parkinson's Disease Questionnaire-39 (PDQ-39). In order to determine predictors of HRQoL in PD, stepwise multiple regression analyses were performed in two ways: before and after removing the emotional well-being dimension from PDQ-39 to control the overlap between depression and anxiety, and HRQoL. RESULTS HRQoL total index was predicted by anxiety, fatigue, motor symptoms, and depression, explaining 26.9%, 7.2%, 2.8%, and 1.9% of the variance. However, after removing overlapping items, HRQoL total index was predicted by fatigue (16.5%), anxiety (6.1%), motor symptoms (3.9%), and neurocognition (2.5%), but not depression. Regarding HRQoL dimensions, mobility and activities of daily living were predicted by fatigue (19.7% and 5%) and UPDRS-III (4% and 10.2%); emotional well-being by fatigue (7.9%); social support by anxiety (12.2%) and UPDRS-III (8.6%); communication by neurocognition (5.3%) and UPDRS-III (3.4%); cognition by anxiety (10.6%) and bodily discomfort by anxiety (23%) and fatigue (4.1%). CONCLUSION These findings showed the importance of identifying and controlling overlapping items of HRQoL and clinical measures to perform an accurate interpretation. HRQoL dimensions showed different predictors before and after controlling the overlap. Based on these results fatigue, anxiety, motor symptoms, and neurocognition, but not depression are the main predictors of HRQoL in PD patients.
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Affiliation(s)
| | - Olaia Lucas-Jiménez
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Natalia Ojeda
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Javier Peña
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | | | | | | | - Nerea Foncea-Beti
- Department of Neurology, Hospital of Galdakao, Galdakao-Usansolo, Spain
| | - Naroa Ibarretxe-Bilbao
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
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Hu Y, Deng F, Zhang L, Hu K, Liu S, Zhong S, Yang J, Zeng X, Peng X. Depression and Quality of Life in Patients with Gliomas: A Narrative Review. J Clin Med 2022; 11:jcm11164811. [PMID: 36013047 PMCID: PMC9410515 DOI: 10.3390/jcm11164811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
In patients with gliomas, depression is a common complication that may cause severe psychological barriers and deteriorate the patient’s quality of life (QoL). Currently, the Hospital Anxiety and Depression Scale (HADS) is the most commonly used tool to diagnose depression in patients with gliomas. Female sex, unmarried status, low education level, high tumor grade, and a history of mental illness may increase the risks of depression and depressive symptoms in patients with gliomas. The QoL of patients with gliomas can be directly reduced by depression. Therefore, the evaluation and intervention of mood disorders could improve the overall QoL of patients with gliomas. Antidepressant use has become a treatment strategy for patients with gliomas and comorbid depression. This narrative review summarizes the current issues related to depression in patients with gliomas, including the prevalence, risk factors, and diagnostic criteria of depression as well as changes in QoL caused by comorbid depression and antidepressant use. The purpose of this review is to guide clinicians to assess the psychological status of patients with gliomas and to provide clinicians and oncologists with a new treatment strategy to improve the prognosis of such patients.
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Affiliation(s)
- Yue Hu
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Fang Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 238 Shangmayuanling Lane, Changsha 410078, China
| | - Lupeng Zhang
- Department of Biochemistry and Molecular Biology, Jishou University School of Medicine, 120 Renmin South Road, Jishou 416000, China
| | - Keyue Hu
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Shiqi Liu
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Suye Zhong
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Jun Yang
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
| | - Xiaomin Zeng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 238 Shangmayuanling Lane, Changsha 410078, China
- Correspondence: (X.Z.); (X.P.)
| | - Xiaoning Peng
- Department of Clinical Medicine, Hunan Normal University School of Medicine, 371 Tongzipo Road, Changsha 410006, China
- Department of Biochemistry and Molecular Biology, Jishou University School of Medicine, 120 Renmin South Road, Jishou 416000, China
- Correspondence: (X.Z.); (X.P.)
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Association between Parkinson's Disease and Psychosocial Factors: Results of the Nationally Representative German Ageing Survey. J Clin Med 2022; 11:jcm11154569. [PMID: 35956184 PMCID: PMC9369499 DOI: 10.3390/jcm11154569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/24/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022] Open
Abstract
Objective: The aim of this study was to clarify the link between Parkinson’s disease (i.e., comparing individuals with Parkinson’s disease and individuals without Parkinson’s disease) and psychosocial outcomes (in terms of life satisfaction, optimism, loneliness, perceived social isolation and perceived autonomy). Methods: Cross-sectional data (wave 5) were used from the nationally representative German Ageing Survey (with n = 7832). Life satisfaction was quantified using the Satisfaction with Life Scale. Optimism was measured using the Brandstädter and Wentura tool. Perceived autonomy was quantified using the Schwarzer tool. Loneliness was quantified using the De Jong Gierveld tool. Perceived social isolation was quantified using the Bude and Lantermann tool. Physician-diagnosed Parkinson’s disease served as the key independent variable. Results: Multiple linear regressions showed that individuals with Parkinson’s disease reported significantly lower perceived autonomy (β = −0.30, p < 0.01) compared to individuals without Parkinson’s disease. In contrast, they did not report worse psychosocial outcomes (in terms of life satisfaction, optimism, loneliness and perceived social isolation). Conclusion: Study findings showed a quite strong association between Parkinson’s disease and perceived autonomy. Future research could elucidate the underlying mechanisms.
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Gu L, Xu H. Effect of cognitive reserve on cognitive function in Parkinson’s disease. Neurol Sci 2022; 43:4185-4192. [DOI: 10.1007/s10072-022-05985-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/25/2022] [Indexed: 11/28/2022]
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Chuquilín-Arista F, Álvarez-Avellón T, Menéndez-González M. Impact of Depression and Anxiety on Dimensions of Health-Related Quality of Life in Subjects with Parkinson's Disease Enrolled in an Association of Patients. Brain Sci 2021; 11:brainsci11060771. [PMID: 34200659 PMCID: PMC8226752 DOI: 10.3390/brainsci11060771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 01/01/2023] Open
Abstract
Parkinson's disease (PD) is a complex disorder characterized by a wide spectrum of symptoms. Depression and anxiety are common manifestations in PD and may be determinants of health-related quality of life (HRQoL). The objective of this study is to determine the association of depression and anxiety with the dimensions of HRQoL in subjects with PD enrolled in an association of patients. Ninety-five community-based patients with PD diagnosis at different disease stages were studied. HRQoL was assessed using the Parkinson's Disease Questionnaire (PDQ-39); depression and anxiety were assessed using the Beck Depression Inventory (BDI-II) and the State-Trait Anxiety Inventory (STAI), respectively. Our results showed that depression and anxiety were negatively associated with HRQoL measured by PDSI. Higher motor dysfunction measured by Hoehn and Yahr (H&Y) staging was also associated with worse HRQoL. Depression was the most influential variable in the model. All PDQ-39 dimensions except social support and bodily discomfort were associated with depression. Anxiety was associated with the emotional well-being and bodily discomfort dimensions. These results suggest that physicians should pay attention to the presence of psychiatric symptoms and treat them appropriately.
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Affiliation(s)
- Fany Chuquilín-Arista
- Community and Family Medicine, Health Area VII—Asturias, Plaza de los Sindicatos Mineros 3, 33600 Mieres, Spain
- Health Science Research, Doctoral School, University of Valladolid, Calle Real de Burgos s/n, 47011 Valladolid, Spain
- Correspondence:
| | - Tania Álvarez-Avellón
- Department of Psychology, Universidad de Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain;
| | - Manuel Menéndez-González
- Department of Neurology, Hospital Universitario Central de Asturias (HUCA), Avenida Roma s/n, 33011 Oviedo, Spain;
- Instituto de Salud del Principado de Asturias (ISPA), Avenida del Hospital Universitario s/n, 33011 Oviedo, Spain
- Department of Medicine, Universidad de Oviedo, Calle Julián Clavería 6, 33006 Oviedo, Spain
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Zhao N, Yang Y, Zhang L, Zhang Q, Balbuena L, Ungvari GS, Zang Y, Xiang Y. Quality of life in Parkinson's disease: A systematic review and meta-analysis of comparative studies. CNS Neurosci Ther 2021; 27:270-279. [PMID: 33372386 PMCID: PMC7871788 DOI: 10.1111/cns.13549] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Studies regarding the impact of Parkinson's disease (PD) on quality of life (QOL) have reported conflicting results, and the underlying QOL domains require further study. In order to understand the association between PD and QOL, we conducted this meta-analysis to systematically compare QOL between PD patients and healthy controls. METHOD The PubMed, PsycINFO, EMBASE, and Web of Science databases were systematically searched. Data were analyzed using the random-effects model. RESULTS Twenty studies covering 2707 PD patients and 150,661 healthy controls were included in the study. Compared with healthy controls, PD patients had significantly poorer QOL overall and in most domains with moderate to large effects sizes. Different QOL measures varied in their association with quality of life, with the Parkinson's Disease Questionnaire-39 (PDQ-39) having the largest effect size (standard mean difference, SMD = -1.384, 95% CI: -1.607, -1.162, Z = 12.189, P < 0.001), followed by the Europe Quality of Life Questionnaire-visual analogue scale (EQ-VAS) (SMD = -1.081, 95% CI: -1.578, -0.584, Z = -4.265, P < 0.001), Europe Quality of Life Questionnaire-5D (EQ-5D) (SMD = -0.889, 95% CI: -1.181, -0.596, Z = -5.962, P < 0.001), and the Short-form Health Survey (SF) scales (physical dimension: SMD = -0.826, 95% CI: -1.529, -0.123, Z = -2.303, P = 0.021; mental dimension: SMD = -0.376, 95% CI: -0.732, -0.019, Z = -2.064, P = 0.039). CONCLUSION PD patients had lower QOL compared with healthy controls in most domains, especially in physical function and mental health. Considering the negative impact of poor QOL on daily life and functional outcomes, effective measures should be developed to improve QOL in this population.
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Affiliation(s)
- Na Zhao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain DisordersInstitutes of Psychological SciencesHangzhou Normal UniversityHangzhouChina
| | - Yuan Yang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain SciencesUniversity of MacauMacao SARChina
- Institute of Advanced Studies in Humanities and Social SciencesUniversity of MacauMacao SARChina
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain ProtectionSchool of Mental HealthCapital Medical UniversityBeijingChina
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain ProtectionSchool of Mental HealthCapital Medical UniversityBeijingChina
| | - Lloyd Balbuena
- Department of PsychiatryUniversity of SaskatchewanSaskatoonSKCanada
| | - Gabor S. Ungvari
- Division of PsychiatrySchool of MedicineUniversity of Western Australia/Graylands HospitalPerthWAAustralia
- The University of Notre Dame AustraliaFremantleWAAustralia
| | - Yu‐Feng Zang
- Center for Cognition and Brain DisordersInstitutes of Psychological SciencesHangzhou Normal UniversityHangzhouChina
| | - Yu‐Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain SciencesUniversity of MacauMacao SARChina
- Institute of Advanced Studies in Humanities and Social SciencesUniversity of MacauMacao SARChina
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Clegg BJ, Duncan GW, Khoo TK, Barker RA, Burn DJ, Yarnall AJ, Lawson RA. Categorising Visual Hallucinations in Early Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2019; 8:447-453. [PMID: 30040741 DOI: 10.3233/jpd-181338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Visual hallucinations (VHs) are common in Parkinson's disease (PD), with prevalence ranging from 27-50% in cross-sectional cohorts of patients with well-established disease. However, minor hallucinations may occur earlier in the disease process than has been previously reported. OBJECTIVE We sought to categorise VHs in a cohort of newly diagnosed PD patients and establish their relationship to other clinical features. METHODS Newly diagnosed PD participants (n = 154) were recruited as part of the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in PD (ICICLE-PD) study. Participants completed the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS III), Montreal Cognitive Assessment (MoCA) and Parkinson's Disease Questionnaire (PDQ-39) to assess motor severity, cognition and quality of life (QoL), respectively. VHs were classified using the North East Visual Hallucinations Inventory. Hierarchical regression was used to build predictive models of motor severity, QoL and cognition. RESULTS 22% (n = 34) of participants experienced recurrent VHs with minor VHs being most frequently reported (64.7% of hallucinators). Complex VHs were present in 32.4% of hallucinating participants. Linear regression showed VHs predicted poorer PDQ-39 and MoCA scores (β= 0.201, p = 0.006 and β= - 0.167, p = 0.01, respectively) but not motor severity (p > 0.05). CONCLUSIONS Over a fifth of people with newly diagnosed PD reported recurrent VHs; minor hallucinations were the most common, although a small proportion reported complex VHs. Recurrent VHs were found to be a significant independent predictor of cognitive function and QoL but not motor severity. Our findings highlight the importance of screening for VHs at diagnosis.
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Affiliation(s)
| | - Gordon W Duncan
- Institute of Neuroscience, Newcastle University, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Tien K Khoo
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Australia.,School of Medicine, University of Wollongong, New South Wales, Australia
| | - Roger A Barker
- John Van Geest Centre for Brain Repair, University of Cambridge, UK
| | - David J Burn
- Faculty of Medical Science, Newcastle University, UK
| | - Alison J Yarnall
- Institute of Neuroscience, Newcastle University, UK.,Newcastle University Institute for Ageing, Newcastle University, UK
| | - Rachael A Lawson
- Institute of Neuroscience, Newcastle University, UK.,Newcastle University Institute for Ageing, Newcastle University, UK
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The impact of levodopa therapy-induced complications on quality of life in Parkinson's disease patients in Singapore. Sci Rep 2019; 9:9248. [PMID: 31239456 PMCID: PMC6593098 DOI: 10.1038/s41598-019-45110-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 05/31/2019] [Indexed: 11/08/2022] Open
Abstract
The objective of this study was to investigate the impact of levodopa therapy-induced complications on the quality of life (QoL) of Parkinson's disease (PD) patients in Singapore over a 1-year follow-up period. 274 PD patients were prospectively recruited, of which 78 patients completed the follow-up. Patients were evaluated on: (1) motor symptoms, (2) non-motor symptoms, (3) levodopa therapy-induced complications and (4) QoL. Levodopa-induced complications including dyskinesia and OFF symptoms occurred in 13.5% and 55.9% of the study population, respectively. In patients who completed the 1-year follow-up, there was a trend suggestive of increasing dyskinesia duration, more disabling dyskinesia as well as longer, more sudden and unpredictable OFF periods. There was a significant decline in the overall QoL at follow-up, in particular, activities of daily living, emotional well-being, cognition and communication domains were the most affected. The multivariable analysis demonstrated that worsening of UPDRS IV total score over 1-year interval was associated with worsening in PDQ-Summary Index score (d = 0.671, p = 0.014). In conclusion, levodopa-induced complications had significant adverse impacts on QoL. This study substantiates the importance for clinicians to closely monitor and promptly manage levodopa therapy-induced complications that may arise in patients.
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Examining Factors Related to Health-Related Quality of Life in People With Parkinson’s Disease. Rehabil Nurs 2018; 45:122-130. [DOI: 10.1097/rnj.0000000000000179] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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13
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Prizer LP, Gay JL, Wilson MG, Emerson KG, Glass AP, Miyasaki JM, Perkins MM. A Mixed-Methods Approach to Understanding the Palliative Needs of Parkinson’s Patients. J Appl Gerontol 2018; 39:834-845. [DOI: 10.1177/0733464818776794] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Parkinson’s disease (PD) is the second-most common age-related neurodegenerative disorder. Despite recommendations for a palliative approach, little is known about what palliative needs are unmet by standard care. This study aims to (a) identify palliative needs of PD patients, (b) determine the relationship between palliative needs and health-related quality of life (HRQoL), and (c) probe into factors affecting HRQoL. PD patients and neurologists were recruited for a survey on palliative need; a subset of patients was interviewed. Significant differences between physicians and patients were found in Physical, Psychological, Social, Financial, and Spiritual domains. Physical and Psychological needs predicted HRQoL. Primary themes across interviews included (a) lack of healthcare education and (b) need for care coordination. Secondary themes included (a) the importance of support groups, (b) the role of spirituality/religion, and (c) the narrow perceived role of the neurologist. Findings highlight the importance of coordinated individualized care.
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He L, Lee EY, Sterling NW, Kong L, Lewis MM, Du G, Eslinger PJ, Huang X. The Key Determinants to Quality of Life in Parkinson's Disease Patients: Results from the Parkinson's Disease Biomarker Program (PDBP). JOURNAL OF PARKINSONS DISEASE 2017; 6:523-32. [PMID: 27258700 DOI: 10.3233/jpd-160851] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The impact of motor- and non-motor symptoms on health-related quality of life (HRQOL) in Parkinson's disease (PD) has received increasing attention. OBJECTIVES To address this, the study explored a large cohort of patients enrolled in the PD Biomarker Program. METHODS The PD Questionnaire-39 (PDQ-39) measured HRQOL, whereas the Unified PD Rating Scale (UPDRS) assessed motor and non-motor symptoms. Determinants of HRQOL in PD patients were identified by stepwise linear regression analysis. The relationship between the PDQ-39 and UPDRS subscale scores then was explored through structural equation modeling. RESULTS The mean disease duration was 6.8 years and the mean PDQ-39 summary index (PDQ-39SI) was 18.4. UPDRS-I (non-motor function) and UPDRS-II (motor questionnaire) scores demonstrated the strongest correlations with PDQ-39SI (r Ϡ 0.4, P < 0.05), whereas UPDRS-III (motor exam) and UPDRS-IV (motor complications) scores were correlated moderately with PDQ-39SI (0.3 < r < 0.4, P < 0.05). Multiple linear stepwise regression analyses showed that age (β= -0.13, P < 0.001), education (β= -0.07, P = 0.008), UPDRS-I (β= 0.32, P = 0.000), and UPDRS-II (β= 0.44, P < 0.001) significantly contributed to HRQOL, and cumulatively accounted for 69.1% of the PDQ-39SI variance. UPDRS-II score was the primary predictor of PDQ-39SI, accounting for 57.3% of the variance, whereas UPDRS-I score accounted for 7.5%. UPDRS-III and -IV and other factors measured did not survive stepwise regression. Structural equation modeling confirmed the association of UPDRS-II (β= 0.67, P < 0.001) and UPDRS-I (β= 0.35, P < 0.001) with the PDQ-39SI. CONCLUSION Both motor and non-motor function scores impacted significantly HRQOL in PD. UPDRS-III, however, has limited contributions to HRQOL although it is used as a main outcome in many clinical trials.
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Affiliation(s)
- Lu He
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA, USA.,School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Eun-Young Lee
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA, USA
| | - Nicholas W Sterling
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA, USA
| | - Lan Kong
- Department of Public School Health, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Mechelle M Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA, USA.,Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA, USA
| | - Paul J Eslinger
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA, USA.,Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA.,Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA.,Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center Hershey, PA, USA.,Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
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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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16
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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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17
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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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García-Ramos R, López Valdés E, Ballesteros L, Jesús S, Mir P. The social impact of Parkinson's disease in Spain: Report by the Spanish Foundation for the Brain. NEUROLOGÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.nrleng.2013.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Chlond M, Bergmann F, Güthlin C, Schnoor H, Larisch A, Eggert K. Patient education for patients with Parkinson’s disease: A randomised controlled trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.baga.2015.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Quality of life and costs in Parkinson's disease: a cross sectional study in Hungary. PLoS One 2014; 9:e107704. [PMID: 25229404 PMCID: PMC4167855 DOI: 10.1371/journal.pone.0107704] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 08/21/2014] [Indexed: 11/19/2022] Open
Abstract
Background Patient reported outcomes and costs of illness are useful to capture some of the multiple effects of a disease and its treatments. Our aim was to assess quality of life (QoL) and costs of Parkinson's disease (PD) in Hungary, and to analyze their associations. Methods A cross-sectional questionnaire survey was conducted in one neurology university clinic. Clinical characteristics, PD related resource utilizations and productivity loss in the past 12 months were recorded; the Hoehn&Yahr (HY) scale, PDQ-39 and EQ-5D questionnaires were applied. Cost calculation was performed from the societal perspective. Results 110 patients (34.5% female) were involved with mean age of 63.3 (SD = 11.3) and disease duration of 8.2 (SD = 5.8) years. PDQ-39 summary score was 48.1 (SD = 13.4). The average EQ-5D score was 0.59 (SD = 0.28), and was significantly lower than the population norm in age-groups 45–74. The correlation was significant between EQ-5D and PDQ-39 (−0.47, p = 0.000), the HY scale and EQ-5D (−0.3416, p = 0.0008) and PDQ-39 (0.3419, p = 0.0006) scores. The total mean cost was €6030.2 (SD = 6163.0)/patient/year (direct medical 35.7%, direct non-medical 29.4%, indirect cost 34.9%). A one year increase in disease duration and 0.1 decrease of the EQ-5D utility score increase the yearly costs by 8 to 10%, and 7.8%, respectively. The effect of the PDQ-39 score on total cost was not significant. Conclusions Disease severity and public health importance of PD are clearly demonstrated by the magnitude of QoL loss. PD-related costs are substantial, but are much lower in Hungary than in Western European countries. Disease duration and EQ-5D score are significant proxy of costs.
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22
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Determinants of the quality of life in Parkinson's disease: Results of a cohort study from Southwest China. J Neurol Sci 2014; 340:144-9. [DOI: 10.1016/j.jns.2014.03.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 02/08/2014] [Accepted: 03/06/2014] [Indexed: 11/22/2022]
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Cognitive reserve in Parkinson's disease: A systematic review and meta-analysis. Parkinsonism Relat Disord 2014; 20:1-7. [DOI: 10.1016/j.parkreldis.2013.08.010] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 08/19/2013] [Accepted: 08/20/2013] [Indexed: 11/19/2022]
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García-Ramos R, López Valdés E, Ballesteros L, Jesús S, Mir P. The social impact of Parkinson's disease in Spain: Report by the Spanish Foundation for the Brain. Neurologia 2013; 31:401-13. [PMID: 23816428 DOI: 10.1016/j.nrl.2013.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 04/17/2013] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Understanding the social and economic impact of Parkinson's disease is essential for resource planning and raising social awareness. DEVELOPMENT Researchers reviewed the data published to date on epidemiology, morbidity and mortality, dependency, and economic impact of Parkinson's disease in Spain. In addition, a study has been carried out in order to define the public and private health care resources of Spanish patients affected by Parkinson's disease by means of an e-mail survey of all neurologists specialising in this disease and belonging to the Spanish Society of Neurology's study group for movement disorders. CONCLUSIONS The incidence and prevalence rates of Parkinson's disease in Spain are similar to those in the rest of Europe. According to current population estimates, there are at least 300.000 patients with Parkinson's disease and one new case per 10.000 habitants per year in Spain. This has a major impact on the patient's quality of life and nearly doubles patient mortality. In addition, the disease generates sizeable costs for the country that may exceed 17.000€ per year per patient; costs will rise due to the ageing of the population and the new therapies employed. Healthcare professionals and administrators dedicate their efforts to providing quality care to patients. Despite the above, we still have a long way to go in order to provide quality, efficient, multidisciplinary, and universal healthcare.
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Affiliation(s)
- R García-Ramos
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital Clínico San Carlos, Universidad Complutense, Madrid, España.
| | - E López Valdés
- Unidad de Trastornos del Movimiento, Servicio de Neurología, Hospital Clínico San Carlos, Universidad Complutense, Madrid, España
| | - L Ballesteros
- Servicio de Neurología, Hospital Universitario Infanta Cristina, Parla, Madrid, España
| | - S Jesús
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, España; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), España
| | - P Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, España; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), España
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Spadaro L, Bonanno L, Di Lorenzo G, Bramanti P, Marino S. Health-related quality of life in Parkinson's disease patients in northeastern Sicily, Italy: (An ecological perspective). Neural Regen Res 2013; 8:1615-22. [PMID: 25206458 PMCID: PMC4145963 DOI: 10.3969/j.issn.1673-5374.2013.17.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 04/18/2013] [Indexed: 11/18/2022] Open
Abstract
Parkinson's disease has a negative impact on health-related quality of life in Parkinson's disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson's disease patients in northeastern Sicily, Italy. Ninety Parkinson's disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi "Bonino-Pulejo" (Messina), were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale (UPDRS-III) scores, the Parkinson Disease Questionnaire-39 Item scores (as a disease-specific measure of health-related quality of life), scores on the Short Form (36) Health Survey Questionnaire (as a generic measure), and answers to a brief checklist were recorded. A total of 85 Parkinson's disease patients (49% males and 51% females; mean age 70.8 ± 8.6 years; mean UPDRS-III 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years) completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.
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Affiliation(s)
- Letteria Spadaro
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
| | - Lilla Bonanno
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
| | - Giuseppe Di Lorenzo
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
| | - Placido Bramanti
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
| | - Silvia Marino
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
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26
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Pontone GM, Williams JR, Anderson KE, Chase G, Goldstein SR, Grill S, Hirsch ES, Lehmann S, Little JT, Margolis RL, Palanci J, Rabins PV, Weiss HD, Marsh L. Pharmacologic treatment of anxiety disorders in Parkinson disease. Am J Geriatr Psychiatry 2013; 21:520-8. [PMID: 23567419 PMCID: PMC3655116 DOI: 10.1016/j.jagp.2012.10.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 09/27/2012] [Accepted: 10/12/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Neither best practices nor an evidence base for the pharmacologic treatment of anxiety in Parkinson disease (PD) has been established. This study investigated pharmacologic treatment of anxiety disorders in idiopathic PD and the associated clinical features. DESIGN Cross-sectional. SETTING Three community-based movement disorder neurology practices. PARTICIPANTS 250 subjects with PD. MEASUREMENTS Anxiety disorder diagnoses were established by consensus using a panel of six psychiatrists with expertise in geriatric psychiatry and movement disorders. Current medications were provided by the treating neurologists at the time of interview. RESULTS Among subjects with anxiety disorders only, 53% were untreated with medications. When anxious subjects with comorbid depressive disorders were included, 70.8% were on medications effective for treatment of anxiety. Subjects with anxiety and comorbid depressive disorders were more likely to be treated for their psychiatric disturbances than subjects with anxiety disorders alone (odds ratio: 8.33), as were subjects with comorbid motor fluctuations (odds ratio: 3.65). There were no differences in the types of anti-anxiety medications used in regard to the presence of depression or motor fluctuations. CONCLUSIONS These findings suggest that over half of nondepressed PD patients with clinically significant anxiety are untreated with medication. A better understanding of the role of clinical features associated with anxiety in PD, such as depression and motor fluctuations, may improve the recognition and treatment of anxiety disorders in this population.
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Affiliation(s)
- Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
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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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Bucks RS, Cruise KE, Skinner TC, Loftus AM, Barker RA, Thomas MG. Coping processes and health-related quality of life in Parkinson's disease. Int J Geriatr Psychiatry 2011; 26:247-55. [PMID: 20626049 DOI: 10.1002/gps.2520] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Accepted: 02/23/2010] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study investigated the predictive value of various coping processes for the psychological and disease specific aspects of health-related quality of life (HRQoL) in Parkinson's disease (PD). METHOD Cross-sectional study of 85 participants with PD using the Ways of Coping Questionnaire (WCQ), Depression, Anxiety, and Stress Scale (DASS-21), quality of life (PDQ-39), and socio-demographic and clinical variables. RESULTS Greater use of planful problem solving coping was found to be significantly associated with better HRQoL in relation to cognitive impairment, communication and bodily discomfort. In addition to greater disease duration, greater use of escape-avoidance coping processes were identified as significant predictors of poorer HRQoL outcomes in the domains of mood and emotional well-being. CONCLUSION Psychological interventions such as mindfulness training, aimed at reducing the use of escape-avoidance copying, may help to improve HRQoL in PD.
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Affiliation(s)
- R S Bucks
- School of Psychology, University of Western Australia, Australia
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Cruise KE, Bucks RS, Loftus AM, Newton RU, Pegoraro R, Thomas MG. Exercise and Parkinson's: benefits for cognition and quality of life. Acta Neurol Scand 2011; 123:13-9. [PMID: 20199518 DOI: 10.1111/j.1600-0404.2010.01338.x] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The benefits of physical exercise for psychological aspects of quality of life (QoL) are well established in normally ageing adults, yet potential benefits for people with Parkinson's disease (PD) have received limited attention. This study evaluated the benefits of exercise for cognitive functioning, mood and disease-specific QoL for people with PD. METHODS Twenty-eight individuals with PD were allocated to an exercise intervention program (EIP, n = 15) or control group (n = 13). The EIP group undertook a programme of progressive anabolic and aerobic exercise twice weekly for 12 weeks. The control group maintained their usual lifestyle. RESULTS Exercise was shown to have selective benefits for cognitive functioning by improving frontal lobe based executive function. No significant effects were demonstrated for mood or disease-specific QoL. CONCLUSIONS These results are consistent with previous research demonstrating selective benefits of exercise for executive function among normal ageing adults and PD.
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Affiliation(s)
- K E Cruise
- Parkinson's Centre, Vario Health Institute, Edith Cowan University, Joondalup, Perth, WA, Australia
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Impact of psychiatric symptoms and sleep disorders on the quality of life of patients with Parkinson's disease. J Neurol 2010; 258:494-9. [PMID: 20957384 DOI: 10.1007/s00415-010-5786-y] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 09/28/2010] [Accepted: 10/01/2010] [Indexed: 10/18/2022]
Abstract
The objective of this study is to assess how the non-motor symptoms of Parkinson's disease (PD), such as depression, cognitive deterioration, neuropsychiatric and sleep disorders, affect the quality of life, and to compare them with the motor symptoms in order to determine their real impact. A cross-sectional study was designed including 99 patients (mean age 68.5 ± 9.9 years, duration of disease 8.7 ± 6.2 years). Demographic data, onset of PD, years on treatment with levodopa (LD), class of dopaminergic drug prescribed, and dosages were obtained. The following scales were used: quality of life (PDQ-39), Unified Parkinson's Disease Rating Scale (UPDRS I-IV), Parkinson Disease Sleep Scale (PDSS) and daytime sleepiness (Epworth), Mini-Mental State Examination, depression (HAM-D), and the neuropsychiatric inventory (NPI-10). The PDQ-39 summary index (PDQ-39 SI) was 24.7 ± 13.2. A linear regression model including all variables showed that four independent variables accounted for 67.2% of the variance in the PDQ-39 SI (F = 33,277; p < 0.001): NPI, PDSS, UPDRS IV, and UPDRS I. When sub-items of the NPI, PDSS and UPDRS IV scales are analyzed, significant correlations (p < 0.001) are found between the PDQ-39 SI and depression, agitation, apathy, anxiety, hallucinations, delusions, incontinence of urine, morning painful posturing, restlessness in bed, morning fatigue, duration of off periods, unpredictable and predictable off periods, early morning dystonia, and sudden off periods. Neuropsychiatric symptoms, especially depression, nighttime sleep disorders such as urinary incontinence, nighttime restlessness, morning fatigue and somnolence, off-period dystonia and motor fluctuations are the variables that most affect the quality of life of patients with PD.
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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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Sproesser E, Viana MA, Quagliato EMAB, de Souza EAP. The effect of psychotherapy in patients with PD: a controlled study. Parkinsonism Relat Disord 2009; 16:298-300. [PMID: 19864172 DOI: 10.1016/j.parkreldis.2009.08.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 06/08/2009] [Accepted: 08/26/2009] [Indexed: 01/25/2023]
Abstract
The purpose of this study was to evaluate whether group psychotherapy was effective in improving of quality of life and would decrease the symptoms of anxiety and depression in Parkinson's disease patients. Sixteen subjects, with idiopathic Parkinson's disease recruited from the school clinical Hospital/UNICAMP. Were randomly divided in to two groups, experimental and control. Parkinson's Disease and Quality of Life - PDQL; Beck Depression Inventory - BDI; State-Trait-Anxiety Inventory - STAI were used to evaluate the patients. The statistical analysis showed significant effect of the interaction group vs. time in depression (0.0009), anxiety (<0.0001) and QuoL (0.0018) and positive changes in depression (0.0029), anxiety (0.0009) and QuoL (0.0047) for the treated group.
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Affiliation(s)
- Erika Sproesser
- Department of Neurology, Faculty of Medical Science, University of Campinas - UNICAMP, Caixa postal 6111, CEP-13083 970 Campinas - Sao Paulo, Brazil.
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Schiehser DM, Han SD, Lessig S, Song DD, Zizak V, Filoteo JV. Predictors of health status in nondepressed and nondemented individuals with Parkinson's disease. Arch Clin Neuropsychol 2009; 24:699-709. [PMID: 19767296 DOI: 10.1093/arclin/acp064] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Recent studies have shown that self-perceived health status (HS) in Parkinson's disease (PD) is associated with motor, cognitive, or mood symptoms, with the greatest association typically occurring with mood. The purpose of this study was to determine if these associations are present in nondepressed and nondemented individuals with PD by using sensitive neuropsychological measures and statistically derived factors from mood and motor scales. The best predictors of poor HS in PD participants (N = 32) without dementia or depression were mood symptoms, specific to self-reported cognitive impairment and anxiety. Bivariate correlations between HS and number of correct categories on the Wisconsin Card Sorting Test and the gait-balance factor from the Unified Parkinson's Disease Rating Scale Part III were also significant or approached significance. These findings suggest that specific mood and cognitive symptoms continue to be important factors in HS in those individuals who lack clinical levels of depression or dementia.
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Affiliation(s)
- Dawn M Schiehser
- Department of Psychiatry, Univeristy of California of San Diego, San Diego, CA, USA
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35
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Pogoda TK, Cramer IE, Meterko M, Lin H, Hendricks A, Holloway RG, Charns MP. Patient and organizational factors related to education and support use by Veterans with Parkinson's disease. Mov Disord 2009; 24:1916-24. [DOI: 10.1002/mds.22516] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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36
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Visser M, van Rooden SM, Verbaan D, Marinus J, Stiggelbout AM, van Hilten JJ. A comprehensive model of health-related quality of life in Parkinson's disease. J Neurol 2008; 255:1580-7. [PMID: 18821041 DOI: 10.1007/s00415-008-0994-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2008] [Revised: 04/11/2008] [Accepted: 05/02/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Insight in how impairments and disabilities related to Parkinson's disease (PD) influence health-related quality of life (HRQoL) is required to review adequacy of current management strategies. METHODS The Scales for Outcomes in Parkinson's disease (SCOPA) evaluation was used to assess impairments and disabilities. HRQoL was assessed with the EuroQol-5D Visual Analogue Scale. 378 patients with PD who participated in the SCOPA/PROPARK cohort were assessed while on their usual treatment. Multiple linear regression analysis and structural equation modelling were used to construct a model of factors that influence HRQoL. RESULTS A model with good fit was constructed that identified various impairments and disabilities as important contributors to HRQoL in PD. Of the disabilities, psychosocial well-being had a larger impact on HRQoL than physical functioning. Of the impairments, depression had the largest contribution to HRQoL, followed by axial motor symptoms, gastrointestinal symptoms, and urinary symptoms. In addition, pain, psychiatric and motor complications, and daytime sleepiness had small but significant influences on HRQoL. CONCLUSION Multiple factors, including disabilities, nonmotor symptoms and axial motor symptoms, affect HRQoL in patients with PD. In patients who are on symptomatic treatment aiming to alleviate mainly motor symptoms, there is a large impact on HRQoL of nonmotor and nondopaminergic symptoms. Research is warranted to develop and evaluate management strategies for the aspects that currently impact on HRQoL as psychosocial well-being, depressive symptoms, axial motor symptoms, gastrointestinal symptoms, and urinary symptoms. These findings call for a multidisciplinary approach in the care of these features.
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Affiliation(s)
- M Visser
- Department of Neurology, K5 Q 92, Leiden University Medical Center, 9600, 2300 RC Leiden, The Netherlands.
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37
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Zhao YJ, Tan LCS, Lau PN, Au WL, Li SC, Luo N. Factors affecting health-related quality of life amongst Asian patients with Parkinson’s disease. Eur J Neurol 2008; 15:737-42. [DOI: 10.1111/j.1468-1331.2008.02178.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Klepac N, Trkulja V, Relja M, Babić T. Is quality of life in non-demented Parkinson's disease patients related to cognitive performance? A clinic-based cross-sectional study. Eur J Neurol 2008; 15:128-33. [PMID: 18217883 DOI: 10.1111/j.1468-1331.2007.02011.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Whilst the association between dementia and poorer health-related quality of life (Hr-QoL) in Parkinson's disease (PD) has been well established, we aimed to explore the relationship between cognitive performance and Hr-QoL in PD without dementia. Consecutive PD patients (n = 124, 54% men, age 60.4 +/- 10.3 years) judged as non-demented based on DSM-IV criteria and Mini Mental State Examination, free of other neurodegenerative diseases or psychotic difficulties and antipsychotic/antidepressive/anxyolitic treatment were assessed in a battery of neuropsychological tests. We used Parkinson's disease questionnaire (PDQ-39) to asses Hr-QoL and Beck's Depression Inventory (BDI) to quantify depression. In the univariate analysis, better performance in each of the tests evaluating visual attention/memory or visuospatial and executive functions was associated with better Hr-QoL. In multivariate analysis [adjustment for BDI score, PD severity and duration, l-dopa dose, age, sex, education, employment status and early PD onset (<50 years of age)] in which these tests were either represented by a common variable identified in a principal components analysis or were considered individually, better cognitive performance was independently associated with better Hr-QoL. The association was conditional on the level of depression, i.e., apparent only in patients with low(er) BDI scores. Cognitive performance appears associated with Hr-QoL even in non-demented PD patients.
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Affiliation(s)
- N Klepac
- Department of Neurology, University Clinical Hospital Center Zagreb, Zagreb University School of Medicine, Zagreb, Croatia.
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39
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Arnold SD, Forman LM, Brigidi BD, Carter KE, Schweitzer HA, Quinn HE, Guill AB, Herndon JE, Raynor RH. Evaluation and characterization of generalized anxiety and depression in patients with primary brain tumors. Neuro Oncol 2008; 10:171-81. [PMID: 18314416 DOI: 10.1215/15228517-2007-057] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To determine clinical and sociodemographic factors that are associated with major neuropsychiatric illnesses among brain tumor patients, we administered a modified version of the Brief Patient Health Questionnaire and a demographic data form to 363 adult neuro-oncology patients. Responses were analyzed to assess for associations between demographic variables, clinical variables, and symptoms consistent with diagnoses of generalized anxiety disorder and/or depression. Multivariate logistic regression analyses showed that female gender was associated with the presence of symptoms of anxiety, depression, and combined anxiety and depression. Lower WHO tumor grade classifications, lower education level, and a history of psychiatric illness also emerged as important predictors of symptoms consistent with anxiety and/or depression. Marital status and presence of past/current medical illness trended toward being significantly associated with depression alone. Patient use of psychiatric medication was not associated with any study variables. Results of the present study suggest several hypotheses to test with neuro-oncology patients in further longitudinal analyses, which would benefit from the inclusion of a wider range of neuropsychiatric symptoms in conjunction with neurocognitive and functional impairment variables.
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Carod-Artal FJ, Vargas AP, Martinez-Martin P. Determinants of quality of life in Brazilian patients with Parkinson's disease. Mov Disord 2007; 22:1408-1415. [PMID: 17516479 DOI: 10.1002/mds.21408] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Our objective was to identify determinants of health-related quality of life (HRQoL) in a cohort of Brazilian patients with Parkinson's disease (PD). Patients were evaluated by means of the Hoehn and Yahr staging (H&Y), Unified Parkinson's Disease Rating Scale (UPDRS), Schwab and England scale (S&E), Mini-Mental State Exam, Geriatric Depression Scale, and Hospital Anxiety and Depression Scale (HADS). HRQol was assessed using the MOS-Short-Form 36 (SF-36), the Parkinson's disease Questionnaire (PDQ-39), and the Scales for Outcomes in Parkinson's Disease-Psychosocial Questionnaire (SCOPA-PS). 144 patients were evaluated (mean age 62 years; 53.5% men; mean duration of illness 6.6 years; median H&Y, 2 (range: 1-4). Mean SCOPA-PS and PDQ-39 Summary Index (SI) were 39.2 and 40.7, respectively. Both, PDQ-39 and SCOPA-PS SIs correlated at a moderate level (r = 0.30-0.50) with H&Y, S&E, total UPDRS, HADS subscales, and SF-36 Physical and Mental Components. PDQ-39 and SCOPA-PS were closely associated (r = 0.73). HRQoL significantly deteriorated as H&Y progressed, as a whole. Mood disturbances, disability, motor complications, and education were independent predictors of HRQoL in the multivariate analysis model. In PD Brazilian patients, HRQoL correlated significantly with diverse measures of severity. Depression showed to be the most consistent determinant of HRQoL, followed by disability, motor complications, and education years. There was a close association between the PDQ-39 and SCOPA-PS summary scores.
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Affiliation(s)
| | - Antonio Pedro Vargas
- Department of Neurology, The Sarah Network of Rehabilitation Hospitals, Sarah Hospital, Brasilia DF, Brazil
| | - Pablo Martinez-Martin
- Neuroepidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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41
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McKinlay A, Grace RC, Dalrymple-Alford JC, Anderson T, Fink J, Roger D. A profile of neuropsychiatric problems and their relationship to quality of life for Parkinson's disease patients without dementia. Parkinsonism Relat Disord 2007; 14:37-42. [PMID: 17627863 DOI: 10.1016/j.parkreldis.2007.05.009] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2007] [Revised: 05/12/2007] [Accepted: 05/22/2007] [Indexed: 11/20/2022]
Abstract
Neuropsychiatric problems are common in Parkinson's disease (PD) but there is little information regarding how they impact on quality of life. PD patients without dementia (49) were assessed for low mood/depression, fatigue, apathy, sleep problems and hallucinations. Measures of quality of life and motor function were also obtained. Over 77% of the patients reported symptoms consistent with one or more neuropsychiatric problems. Low mood/depression, anxiety and the presence of hallucinations predicted poorer quality of life after controlling for motor symptoms. Additional to the motor symptoms, we found that specific neuropsychiatric problems may impact on quality of life for PD patients.
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Affiliation(s)
- A McKinlay
- Psychology Department, University of Canterbury, PO Box 1485, Private Bag 4800, Christchurch, Canterbury 8004, New Zealand.
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42
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Macht M, Pasqualini MS, Taba P. Cognitive-behavioral Strategies for Parkinson’s Disease: A Report of Three Cases. J Clin Psychol Med Settings 2007. [DOI: 10.1007/s10880-007-9065-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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43
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Marchionini DM, Lehrmann E, Chu Y, He B, Sortwell CE, Becker KG, Freed WJ, Kordower JH, Collier TJ. Role of heparin binding growth factors in nigrostriatal dopamine system development and Parkinson's disease. Brain Res 2007; 1147:77-88. [PMID: 17368428 DOI: 10.1016/j.brainres.2007.02.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Revised: 11/11/2006] [Accepted: 02/06/2007] [Indexed: 11/17/2022]
Abstract
The developmental biology of the dopamine (DA) system may hold important clues to its reconstruction. We hypothesized that factors highly expressed during nigrostriatal development and re-expressed after injury and disease may play a role in protection and reconstruction of the nigrostriatal system. Examination of gene expression in the developing striatum suggested an important role for the heparin binding growth factor family at time points relevant to establishment of dopaminergic innervation. Midkine, pleiotrophin (PTN), and their receptors syndecan-3 and receptor protein tyrosine phosphatase beta/zeta, were highly expressed in the striatum during development. Furthermore, PTN was up-regulated in the degenerating substantia nigra of Parkinson's patients. The addition of PTN to ventral mesencephalic cultures augmented DA neuron survival and neurite outgrowth. Thus, PTN was identified as a factor that plays a role in the nigrostriatal system during development and in response to disease, and may therefore be useful for neuroprotection or reconstruction of the DA system.
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Affiliation(s)
- Deanna M Marchionini
- Dept. Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
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Macht M, Gerlich C, Ellgring H, Schradi M, Rusiñol AB, Crespo M, Prats A, Viemerö V, Lankinen A, Bitti PER, Candini L, Spliethoff-Kamminga N, de Vreugd J, Simons G, Pasqualini MS, Thompson SBN, Taba P, Krikmann U, Kanarik E. Patient education in Parkinson's disease: Formative evaluation of a standardized programme in seven European countries. PATIENT EDUCATION AND COUNSELING 2007; 65:245-52. [PMID: 16965885 DOI: 10.1016/j.pec.2006.08.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2006] [Revised: 08/01/2006] [Accepted: 08/06/2006] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To evaluate a newly developed education programme for Parkinson's disease (PD) patients. METHODS The programme consisted of eight sessions and aimed at improving knowledge and skills related to self-monitoring, health promotion, stress management, depression, anxiety, social competence, and social support, all with special reference to PD. The programme was formatively evaluated in seven European countries (Spain, Finland, Italy, The Netherlands, United Kingdom, Estonia, Germany) with 151 patients diagnosed with idiopathic PD. The evaluation included patients' ratings of the comprehensibility and feasibility of the programme as well as mood ratings before and after each session. Patients also completed questionnaires at the beginning and end of the programme to explore possible changes in disease-related psychosocial problems, quality of life, and depression. RESULTS The programme was feasible to run, and patients were able to understand its elements. Patients reported mood elevations following individual sessions and reduced disease-related psychosocial problems after completing the programme. There were no substantial differences in results between cultures. CONCLUSION Patient education appears to have potential as a useful and feasible intervention, complementing medical treatment in PD. PRACTICE IMPLICATIONS The present programme will soon be available in seven European languages and can be tested in different health care systems.
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Affiliation(s)
- Michael Macht
- Department of Psychology, University of Würzburg, Marcusstrasse 9-11, 97070 Würzburg, Germany.
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Gómez-Esteban JC, Zarranz JJ, Lezcano E, Tijero B, Luna A, Velasco F, Rouco I, Garamendi I. Influence of motor symptoms upon the quality of life of patients with Parkinson's disease. Eur Neurol 2007; 57:161-5. [PMID: 17213723 DOI: 10.1159/000098468] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2006] [Accepted: 10/30/2006] [Indexed: 11/19/2022]
Abstract
We studied the impact of various motor and nonmotor symptoms upon quality of life in patients with Parkinson's disease (PD). The study comprised 110 patients with PD (age: 68.6 years, course of the disease: 7.6 years). The Unified Parkinson Disease Rating Scale (UPDRS; I-IV) and Parkinson's Disease Questionnaire (PDQ-39) were recorded. We recorded the correlations between years of disease and UPDRS IV, as well as PDQ-39 and UPDRS I, II, III and IV. Introduction of all variables into a linear regression model showed that 3 variables accounted for 51% of the variance in PDQ-39. Mental condition, gait disorders and complications of dopaminergic drugs are the variables that most affect the quality of life of patients with PD.
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Affiliation(s)
- J C Gómez-Esteban
- Neurology Service, Movement Disorders Unit, Hospital of Cruces, Baracaldo, and Neurosciences Department, Basque Country University, Bilbao, Spain.
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Den Oudsten BL, Van Heck GL, De Vries J. Quality of life and related concepts in Parkinson's disease: A systematic review. Mov Disord 2007; 22:1528-37. [PMID: 17523198 DOI: 10.1002/mds.21567] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Several studies have investigated the quality of life (QOL) of patients with Parkinson's disease (PD). The purpose of this study was to review the conceptual and methodological quality of quality of life (QOL) studies among patients with PD and to identify factors associated with poor (HR)QOL. Computerized bibliographic databases were screened for publications from 1960 to January 2007. According to a list of predefined criteria, the methodological quality of the 61 studies, was moderate. The term 'QOL' was often used inappropriately. In fact, almost all studies in this review actually assessed health status (HS) instead of QOL. The functioning of patients with PD on physical, social, and emotional domains is affected by PD. Their HS seems to be lower when compared to healthy persons or patients with other chronic diseases. HS studies augment the insight in self-perceived functioning. Therefore, HS is conceived as a valuable construct. However, QOL is also an important factor in health care. Attention towards QOL is needed in order to draw valid conclusions regarding a person's subjective experience of well-being in a broad sense. In order to accomplish this, future studies should apply the QOL concept with more rigor, should use an adequate operational definition, and should employ sound measures.
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Affiliation(s)
- Brenda L Den Oudsten
- Medical Psychology, Department of Psychology and Health, Tilburg University, and St. Elisabeth Hospital, Tilburg, The Netherlands.
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47
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Costa A, Peppe A, Carlesimo GA, Pasqualetti P, Caltagirone C. Major and minor depression in Parkinson's disease: a neuropsychological investigation. Eur J Neurol 2006; 13:972-80. [PMID: 16930363 DOI: 10.1111/j.1468-1331.2006.01406.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Previous studies have failed to distinguish the differential contribution of major and minor depression to cognitive impairment in patients with idiopathic Parkinson's disease (PD). This study was aimed at investigating the relationships among major depression (MD), minor depression (MiD) and neuropsychological deficits in PD. Eighty-three patients suffering from PD participated in the study. MD and MiD were diagnosed by means of a structured interview (SCID-I) based on the DSM-IV criteria, and severity of depression was evaluated by the Beck Depression Inventory. For the neuropsychological assessment, we used standardized scales that measure verbal and visual episodic memory, working memory, executive functions, abstract reasoning and visual-spatial and language abilities. MD patients performed worse than PD patients without depression on two long-term verbal episodic memory tasks, on an abstract reasoning task and on three measures of executive functioning. The MiD patients' performances on the same tests fell between those of the other two groups of PD patients but did not show significant differences. Our results indicate that MD in PD is associated with a qualitatively specific neuropsychological profile that may be related to an alteration of prefrontal and limbic cortical areas. Moreover, the same data suggest that in these patients MiD and MD may represent a gradual continuum associated with increasing cognitive deficits.
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Affiliation(s)
- A Costa
- I.R.C.C.S. Fondazione Santa Lucia, Rome, Italy.
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Dowding CH, Shenton CL, Salek SS. A Review of the Health-Related Quality of Life and Economic Impact of Parkinson??s Disease. Drugs Aging 2006; 23:693-721. [PMID: 17020395 DOI: 10.2165/00002512-200623090-00001] [Citation(s) in RCA: 138] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Parkinson's disease (PD) is a chronic, neurodegenerative disease that places a substantial burden on patients, their families and carers, as well as on society as a whole. PD can severely affect the health-related quality of life (HR-QOL) of both patients and their carers and, as the disease progresses, HR-QOL deteriorates. This review aims to critically evaluate the literature on a number of important aspects that influence HR-QOL in relation to PD. Factors associated with a negative impact and ways to improve HR-QOL are highlighted, and tools for HR-QOL assessment reviewed. The economic impact of PD and related cost-effectiveness studies are also reviewed. Over the course of the disease, patients with PD experience changes in their HR-QOL that are affected by factors such as depression, motor complications, education and surgery. However, a lack of uniformity in the choice of HR-QOL tools used in studies makes comparison of results difficult. Research on motor fluctuations and dyskinesias has shown conflicting results, whereas it is clear from the available data that depression needs to be more clearly recognised and treated. Inequality in the numbers of men and women receiving surgery still needs to be addressed and, again, in this area there is a lack of uniformity with respect to assessment for surgery. Education programmes have been shown to be successful in improving HR-QOL, although more research is needed about how to introduce such programmes to all PD patients. In particular, there has been little detailed research into young-onset PD and juvenile patients to assess the true impact of the disease on their HR-QOL. The literature has also shown that PD can affect the HR-QOL of the carer, which may have a 'knock-on' effect for the patient. The HR-QOL of carers needs more attention because these individuals can significantly reduce the burden that would otherwise fall on the health services in terms of cost and care. Research shows that the economic costs of PD are high, particularly for patients in advanced stages of the disease and those with motor complications. Although carer burden is a major source of costs, this is not factored into cost-effectiveness analyses. Furthermore, because too few studies use quality-adjusted life years as their health outcome, particularly in studies of the costs of surgery, comparison of costs of treatments is difficult. The review highlights the need for HR-QOL tools such as the EuroQol-5D to be used together with disease-specific tools to provide the most comprehensive picture of the costs and impact of PD.A recent upsurge in published literature on PD resulting from increased interest in HR-QOL issues has led to an at times overwhelming amount of new information. The present review assembles the most important points relating to HR-QOL in PD raised in the literature, adds value to previously covered issues, and examines areas of HR-QOL in PD that have not previously been reviewed, such as education, carer burden and surgery, highlighting where more research is warranted.
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Affiliation(s)
- Clare H Dowding
- Welsh School of Pharmacy, Centre for Socioeconomic Research, Cardiff University, Cardiff, UK
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Kitagawa M, Tashiro K. Low-dose levodopa therapy in Japanese patients with Parkinson's disease: a retrospective study. Intern Med 2005; 44:939-43. [PMID: 16258207 DOI: 10.2169/internalmedicine.44.939] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To investigate the efficacy and the rate of adverse events of chronic low-dose levodopa-carbidopa therapy in Japanese patients with Parkinson's disease (PD). PATIENTS AND METHODS A total of 92 Japanese PD patients treated with low doses of levodopa from the outset were studied. Both disease-specific motor disabilities and quality of life (QOL) in the patients were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) and the Parkinson's Disease 39 Quality of Life Questionnaire (PDQ39), respectively. RESULTS In the overall patient group, the mean duration of treatment, the mean daily dose of levodopa, the disability scores and the motor scores of UPDRS were 6.2 years, 186.4 mg, 8.0 and 19.2, respectively. The rates of motor fluctuations, dyskinesias and hallucinations were 8.7%, 6.5% and 14.1%, respectively. The mean summary index of PDQ39 scores was 23.1. Patients with motor fluctuations showed a significantly earlier disease onset. Dose of levodopa, age at onset, and treatment duration were not associated with the occurrence of dyskinesias. Patients with hallucination had higher doses of levodopa and dopamine agonist. CONCLUSIONS Our results demonstrate that chronic administration of a low-dose levodopa preparation can provide satisfactory benefit with a low incidence of motor complications, and can result in good QOL in Japanese patients with PD. The concomitant use of a small amount of dopamine agonist and amantadine from the outset has partly contributed to a reduced dose of levodopa and the lesser occurrence of motor complications.
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Affiliation(s)
- Mayumi Kitagawa
- Department of Neurology, Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
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Abstract
OBJECTIVE To identify patterns of psychological problems in Parkinson's disease (PD). METHOD A sample of 3075 patients was surveyed to determine frequencies of psychological problems and cross-validated cluster analyses were computed to identify patterns of these problems. RESULTS An increase of symptoms during arousal was reported by 68%, sleep disturbances by 32% of the sample, and sexual problems by 57% of men and 22% of women. Less frequently reported were difficulties in communicating (27%), needing help of others (38%), and depressive moods (20%). Four patterns of psychological problems were identified: general low stress, general high stress, sexual and social problems, and non-social problems. CONCLUSION The study confirms the clinical observation that PD patients differ not only in degree, but also in structure of psychological stress. Social and non-social stress constitute principal types of stress experienced in PD. This distinction should be taken into account for any approach to support people with PD.
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Affiliation(s)
- M Macht
- Department of Psychology, University of Würzburg, Würzburg, Germany.
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