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Du S, Qin Y, Han M, Huang Y, Cui J, Han H, Ge X, Bai W, Zhang X, Yu H. Longitudinal Mediating Effect of Depression on the Relationship between Excessive Daytime Sleepiness and Activities of Daily Living in Parkinson's Disease. Clin Gerontol 2024; 47:426-435. [PMID: 35951004 DOI: 10.1080/07317115.2022.2111014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Whether depression affects activities of daily living (ADLs) in patients with Parkinson's disease (PD) via excessive daytime sleepiness (EDS) remains unclear; moreover, few longitudinal studies have been conducted. METHODS We recruited 421 patients from the Parkinson's Progression Markers Initiative. We constructed a latent growth mediation model to explore the longitudinal mediating effect of depression on the relationship between EDS and ADLs. RESULTS EDS (p < .001) and depression scores (p < .001) both increased, and ADL scores (p < .001) decreased. Moreover, EDS was positively correlated with depression, whereas an increase in EDS significantly reduced ADLs. The initial value (95% confidence interval [CI]: 0.026, 0.154) and the rate of change (95% CI: 0.138, 0.514) of self-reported depression measured using the Geriatric Depression Scale(GDS) partially mediated the association between EDS and ADL score. CONCLUSIONS The indirect effect of the longitudinal changes of depression on the relationship between EDS and ADLs highlights the importance of depression changes in PD patients with EDS. CLINICAL IMPLICATIONS Depression should be considered a mediator by clinicians; preventing the worsening of depression is essential for improving ADLs in patients with PD, especially those with EDS.
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Affiliation(s)
- Sidan Du
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yao Qin
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Min Han
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Ying Huang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jing Cui
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Hongjuan Han
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xiaoyan Ge
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Wenlin Bai
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xinnan Zhang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Hongmei Yu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
- Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, China
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Cho S, Park K, Jung D, Son G, Cho E, Choi KH. Development and validation of the core life activities scale. Front Psychol 2024; 15:1359276. [PMID: 38711750 PMCID: PMC11070542 DOI: 10.3389/fpsyg.2024.1359276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/04/2024] [Indexed: 05/08/2024] Open
Abstract
Life activities profoundly influence well-being, mental health, and quality of life. The COVID-19 pandemic has heightened the importance of monitoring these activities for psychological and emotional health. However, existing measurement tools are limited, particularly for assessing psychological health. To address this gap, we developed and validated the Core Life Activities (CORE) scale, comprising five key factors (sleep, exercise, learning, diet, and social relationships) identified in neuroscience, cognitive psychology, and gerontology. In Study 1 (n = 1,137), exploratory and confirmatory factor analyses supported a single-factor structure with good model fit (χ2 = 6.377, df = 3, TLI = 0.992, CFI = 0.998, RMSEA = 0.031), demonstrating robust internal consistency (Cronbach's alpha = 0.776) and test-retest reliability (intraclass correlation coefficient = 0.522, p < 0.001). The CORE exhibited significant convergent validity with mental health screening tools for depressive and anxiety disorders and suicidality. Study 2 (n = 684) confirmed a significant correlation between CORE and the World Health Organisation Quality of Life Brief Version, complementing the convergent validity found in Study 1. In addition, discriminant validity was confirmed by a non-significant correlation with the COVID-19 Preventive Behavior Scale. The findings establish the CORE as a reliable and valid tool, offering a simple yet comprehensive measure for assessing core life activities with potential applications in diverse environments.
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Affiliation(s)
- Surin Cho
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Kiho Park
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Dawoon Jung
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Gaeun Son
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Eunsil Cho
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
- Mindeep CBT Center, Seoul, Republic of Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
- Mindeep CBT Center, Seoul, Republic of Korea
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Rosenblum S, Meyer S, Richardson A, Hassin-Baer S. Early identification of subjective cognitive functional decline among patients with Parkinson's disease: a longitudinal pilot study. Sci Rep 2022; 12:22242. [PMID: 36564494 PMCID: PMC9789081 DOI: 10.1038/s41598-022-26280-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/13/2022] [Indexed: 12/25/2022] Open
Abstract
Practical methods for early identification of Parkinson's disease (PD) mild cognitive impairment (PD-MCI) through changes in real-life daily functioning are scarce. The aim of the study was to examine whether the cognitive functional (CF) feature, comprising of seven self-reported Movement Disorder Society's (MDS) Unified Parkinson's Disease Rating Scale (UPDRS) items, predicts PD patients' cognitive functional status after a year. We conducted a 1-year follow-up of 34 PD patients (50-78 year; 70.6% men) suspected of MCI using the following measures: the MDS-UPDRS, UPDRS-CF feature, Beck Depression Inventory (BDI), Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Parkinson's Disease Cognitive Functional Rating Scale (PD-CFRS), and Daily Living Questionnaire (DLQ). The first and second UPDRS-CF feature scores, and additional measures at the 1-year follow-up significantly correlated. Hierarchical regression revealed that the initial MoCA, TMT, and BDI scores predicted the second UPDRS-CF, and the first UPDRS-CF predicted 31% of the second PD-CFRS score variance. Depression moderated the relationship between the first UPDRS-CF score and the DLQ Part A. These results suggest practical, self-reported, daily functional markers for identifying gradual decline in PD patients. They consider the patients' heterogeneity, underlying cognitive pathology, and implications on daily functioning, health, and well-being.
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Affiliation(s)
- Sara Rosenblum
- grid.18098.380000 0004 1937 0562Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, 3498838 Israel
| | - Sonya Meyer
- grid.411434.70000 0000 9824 6981Department of Occupational Therapy, Ariel University, Ariel, 4077603 Israel
| | - Ariella Richardson
- grid.419646.80000 0001 0040 8485Department of Industrial Engineering, Jerusalem College of Technology, Jerusalem, 9372115 Israel
| | - Sharon Hassin-Baer
- grid.413795.d0000 0001 2107 2845Movement Disorders Institute, Sheba Medical Centre, Ramat-Gan, 5262000 Israel ,grid.413795.d0000 0001 2107 2845Department of Neurology, Sheba Medical Centre, Ramat-Gan, 5262000 Israel ,grid.12136.370000 0004 1937 0546Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801 Israel
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4
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Choi HS, Cho SH. Effects of Multimodal Rehabilitation on the Activities of Daily Living, Quality of Life, and Burden of Care for Patients with Parkinson's Disease: A Randomized Control Study. Healthcare (Basel) 2022; 10:healthcare10101888. [PMID: 36292335 PMCID: PMC9602406 DOI: 10.3390/healthcare10101888] [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: 08/31/2022] [Revised: 09/24/2022] [Accepted: 09/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Parkinson’s disease reduces patients’ function, activities of daily living, and quality of life, and increases their guardians’ burden of care. This study verified the effectiveness of a multimodal rehabilitation programme for patients with Parkinson’s disease. Trial design: This study was a multicentre parallel randomised controlled, single-blind, trial conducted in three hospitals in Korea. Methods: A central randomisation centre used computer generated tables to randomly allocate 60 of 75 patients with Parkinson’s disease who fulfilled the study requirements into experimental (n = 30; multimodal rehabilitation; consisting of daily living training, guardian education, home environment modification, fine muscle exercise, balance training, and training using auxiliary tools performed 50 min per session, twice a week, in 10 sessions) and control (n = 30; traditional rehabilitation; consisting of task-oriented training, joint exercise, and daily living training performed 50 min per session, twice a week, in 10 sessions) groups. Results: Multimodal rehabilitation for Parkinson’s disease significantly improved the activities of daily living (p < 0.01) and quality of life of patients (p < 0.001) and eased the guardians’ burden of care (p < 0.001). Conclusions: Multimodal rehabilitation is suggested to improve activities of daily living, quality of life of patients with Parkinson’s disease, and reduce the burden of care of their guardians.
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Affiliation(s)
- Hyun-Se Choi
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Seung-Hyun Cho
- Department of Occupational Therapy, College of Health Sciences and Social Welfare, Woosuk University, Wanju 55338, Korea
- Correspondence: ; Tel.: +82-63-290-1525
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5
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Huang Y, Du S, Chen D, Qin Y, Cui J, Han H, Ge X, Bai W, Zhang X, Yu H. The path linking excessive daytime sleepiness and activity of daily living in Parkinson’s disease: the longitudinal mediation effect of autonomic dysfunction. Neurol Sci 2022; 43:4777-4784. [DOI: 10.1007/s10072-022-06081-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/15/2022] [Indexed: 10/18/2022]
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Read J, Frost R, Walters K, Tuijt R, Manthorpe J, Maydon B, Pigott J, Schrag A, Davies N. Transitions and challenges for people with Parkinson's and their family members: A qualitative study. PLoS One 2022; 17:e0268588. [PMID: 35849560 PMCID: PMC9292070 DOI: 10.1371/journal.pone.0268588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/02/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To explore the experiences and challenges of people with Parkinson's and their family members living in the community through the lens of their transitions to better understand the phases and changes in their lives. DESIGN Qualitative study using semi-structured interviews and analysed using codebook thematic analysis. SETTING/PARTICIPANTS Purposive sampling was used in primary and secondary healthcare services across Southern England in 2019 to recruit 21 people with Parkinson's (aged between 45-89 years) and 17 family members (13 spouses and 4 adult children, aged between 26-79 years). RESULTS Participants' descriptions were classified in three main phases of transition from a place of health towards greater dependency on others: 1) 'Being told you are a person with Parkinson's' (early), 2) 'Living with Parkinson's' (mid), and 3) 'Increasing dependency' (decline). Seven sub-themes were identified to describe the transitions within these three phases: phase 1: receiving and accepting a diagnosis; navigating reactions; phase 2: changing social interactions and maintaining sense of self; information: wanting to know but not wanting to know; finding a place within the healthcare system; and 3: changes in roles and relationships; and increasingly dependent. CONCLUSION This study has identified points of change and means of supporting key transitions such as diagnosis, changes in social connections, and increased use of secondary healthcare services so that comprehensive, holistic, individualised and well-timed support can be put in place to maintain well-being.
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Affiliation(s)
- Joy Read
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Rachael Frost
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Kate Walters
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Remco Tuijt
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London, London, United Kingdom
| | - Bev Maydon
- Member of Patient and Public Involvement (PPI Group), London, United Kingdom
| | - Jennifer Pigott
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Nathan Davies
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom
- * E-mail:
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7
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Ma J, Dou K, Liu R, Liao Y, Yuan Z, Xie A. Associations of Sleep Disorders With Depressive Symptoms in Early and Prodromal Parkinson's Disease. Front Aging Neurosci 2022; 14:898149. [PMID: 35754965 PMCID: PMC9226450 DOI: 10.3389/fnagi.2022.898149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/26/2022] [Indexed: 12/24/2022] Open
Abstract
Background Non-motor symptoms, including sleep disorders and depression, are common in Parkinson’s disease (PD). The purpose of our study is to explore the effect of sleep disorders, including the probable rapid eye movement (REM) sleep behavior disorder (pRBD) and the daytime sleepiness, on depressive symptoms in patients with early and prodromal PD. Methods A total of 683 participants who obtained from the Parkinson Progression Markers Initiative (PPMI) were included, consisting of 423 individuals with early PD, 64 individuals with prodromal PD, and 196 healthy controls (HCs), who were followed up to 5 years from baseline. Multiple linear regression models and linear mixed-effects models were conducted to explore the relationship between sleep disorders and depression at baseline and longitudinally, respectively. Multiple linear regression models were used to further investigate the association between the change rates of daytime sleepiness score and depression-related score. Mediation analyses were also performed. Results At baseline analysis, individuals with early and prodromal PD, who had higher RBD screening questionnaire (RBDSQ) score, or who were considered as pRBD, or who manifested specific behaviors of RBD (things falling down when sleep or disturbance of sleep), showed significantly the higher score of depression-related questionnaires. Our 5-year follow-up study showed that sleep disorders, including pRBD and daytime sleepiness, were associated with the increased depressive-related score in individuals with early and prodromal PD. Interestingly, we also found that the increased possibilities of daytime sleepiness were associated with depressive-related score. Finally, mediation analysis demonstrated that the relationship between RBD and depressive symptoms was partially mediated by autonomic symptoms, such as postural hypertension, salivation, dysphagia, and constipation. Conclusion Our study shows that sleep disorders, including pRBD and daytime sleepiness, are associated with depression at baseline and longitudinally, which is partially mediated by the autonomic dysfunction in early and prodromal PD, with an implication that sleep management is of great value for disease surveillance.
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Affiliation(s)
- Jiangnan Ma
- Departmentof Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Kaixin Dou
- Departmentof Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ruize Liu
- Department of Intensive Care Unit, Affiliated Qingdao Municipal Hospital of Qingdao University, Qingdao, China
| | - Yajin Liao
- The Brain Science Center, Beijing Institute of Basic Medical Sciences, Beijing, China
| | - Zengqiang Yuan
- Departmentof Neurology, Affiliated Hospital of Qingdao University, Qingdao, China.,The Brain Science Center, Beijing Institute of Basic Medical Sciences, Beijing, China
| | - Anmu Xie
- Departmentof Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
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8
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Abdi A, Doulatyari PK, Mahmodi M, Torabi Y. Relationship of spiritual wellbeing with life expectancy and quality of life for patients living with heart failure. Int J Palliat Nurs 2022; 28:262-269. [PMID: 35727830 DOI: 10.12968/ijpn.2022.28.6.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Aim: Spirituality is a crucial dimension in human health. However, it is often overlooked in patients with heart failure (HF) in Iran. Thus, the purpose of this study was to determine the relationship between spiritual wellbeing, life expectancy and quality-of-life (QOL) in patients with HF. Methods: This cross-sectional study was performed with 150 HF patients, who were enrolled through convenience sampling. Data were collected using a questionnaire comprising four parts: the Minnesota Living with Heart Failure Questionnaire, Schneider's life expectancy instrument, Ellison's and Paulotzin's (1982) Spiritual Well-Being Scale, and a demographic checklist. SPSS software was used for data analysis. Results: In this study, mean and standard deviation of QOL, life expectancy and spiritual wellbeing were 41.82±19.17, 30.20±4.58 and 87.80±5.28 respectively. There was a significant relationship between spiritual wellbeing and quality of life (r=-0.633, P<0.001) and also life expectancy (r=0.544, P<0.001). Quality of life and life expectancy were significantly higher in men than in women. Linear regression tests showed that the existential and religious dimensions of spirituality could influence 44.9% of the QOL variance (F=54.54, P<0.001) and increased values of existential spirituality would improve QOL by an average of 3.45 units. Improving life expectancy also raised QOL by 14.0% (F=21.26, P<0.001). This study also demonstrated that life expectancy is impacted by spiritual health, with a variance of 34.2%, in which the role of existential-spiritual health is of particular significance (t=7.10, P<0.001). Conclusion: The results revealed that spiritual wellbeing, especially the existential type, enhances life expectancy and quality-of-life among HF patients. Therefore, it is recommended that healthcare professionals design a comprehensive and supportive care model for the promotion of spiritual wellbeing in HF patients.
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Affiliation(s)
- Alireza Abdi
- Associate Professor of Nursing, Kermanshah University of Medical Sciences, Iran
| | | | - Milad Mahmodi
- Nursing Student, Kermanshah University of Medical Sciences, Iran
| | - Yousef Torabi
- Nursing Student, Kermanshah University of Medical Sciences, Iran
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9
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Tosin MH, Simuni T, Stebbins GT, Cedarbaum JM. Tracking Emergence of New Motor and Non-Motor Symptoms Using the MDS-UPDRS: A Novel Outcome Measure for Early Parkinson’s Disease? JOURNAL OF PARKINSON'S DISEASE 2022; 12:1345-1351. [PMID: 35466955 PMCID: PMC9198734 DOI: 10.3233/jpd-223170] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: Summary scores of current clinical rating scales do not appear sensitive enough to quantify changes in disease progression in early Parkinson’s disease (PD) clinical trials. An alternate approach might be to track the appearance of new or emergent symptoms (ES) over time as a measure of disease progression. Objective: Explore the potential utility of patient reported ES as an outcome measure during the early phase of PD. Methods: We analyzed data from the MDS-UPDRS Parts IB (non-motor) and II (motor) Experiences of Daily Living scales over two years in the STEADY-PD3 study. We assessed the number of ES reported in each part of the scale in both participants who started symptomatic treatment and those who did not (STx-yes/no) in two periods: between 0 and 12-months (Year 1), and 13 and 24-months (Year 2). Results: Of 331 participants, 87% developed ES, and 55% started STx in Year 1. The median number of Part IB ES did not significantly differ between STx groups, but ES in Part II were significantly more frequent in the STx-yes group. Of 148 participants who remained STx-no into Year 2, 77% developed ES, and 42% started STx. Again, Part II, but not Part IB ES were more frequent the STx-yes group. Using these results, a sample size of ∼90 per group would be required to detect a 30% reduction in combined Part IB and II ES over 12 months. Conclusion: Assessing ES of patient-reported experiences of daily living may provide a useful marker for tracking PD progression.
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Affiliation(s)
- Michelle H.S. Tosin
- Department of Nursing, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Tanya Simuni
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Glenn T. Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Jesse M. Cedarbaum
- Coeruleus Clinical Sciences LLC, Woodbridge, CT, USA
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
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10
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Zhu B, Kohn R, Patel A, Koo BB, Louis ED, de Figueiredo JM. Demoralization and Quality of Life of Patients with Parkinson Disease. PSYCHOTHERAPY AND PSYCHOSOMATICS 2022; 90:415-421. [PMID: 33601384 DOI: 10.1159/000514270] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/07/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Demoralization is quite prevalent in patients with Parkinson disease (PD). Unrecognized or untreated, demoralization may progress, at times, to demands for euthanasia and the desire for suicide. Typically, patients with PD do not complain of being "demoralized"; rather, they report disruptions in the quality of their lives. Hence, early identification of disruptions in health-related quality of life (HRQoL) specifically associated with demoralization may prompt earlier recognition and treatment. Published data on such associations, however, could not be found. Alleviation of demoralization in PD is likely to improve treatment outcomes. OBJECTIVE This research aimed at identifying the disruptions of HRQoL specifically associated with the demoralization of patients with PD. METHODS Consecutive general hospital outpatients with PD (n = 95) were assessed for: demoralization, with the Diagnostic Criteria for Psychosomatic Research Demoralization Scale (DCPR-D) and the Demoralization Scale (DS); depression, with the Patient Health Questionnaire-9 (PHQ-9); HRQoL, with the Parkinson Disease Questionnaire-Short Form (PDQ-8); sociodemographic variables; medical comorbidities; PD severity; and types of treatment. RESULTS The prevalence of demoralization was 19%. Regression analyses showed that demoralization was significantly more likely to be experienced by participants who had difficulty with mobility and felt embarrassed in public due to having PD. Demoralization explained HRQoL over and above depression. CONCLUSIONS Stigma and perceived difficulty with mobility are associated with demoralization of PD patients, and they may signal the need for psychotherapeutic and behavioral interventions to prevent the progression to helplessness, hopelessness, demands for euthanasia, and desire for suicide.
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Affiliation(s)
- Boheng Zhu
- Department of Psychology, University of Bologna, Bologna, Italy.,Formerly at the Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Robert Kohn
- Department of Psychiatry, Brown University School of Medicine, Providence, Rhode Island, USA
| | - Amar Patel
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Brian B Koo
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Elan D Louis
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Formerly at the Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - John M de Figueiredo
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA,
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11
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Chiu SF, Wu YR, Tsay PK, Chiu YC. The Mediating Effect of Spiritual Well-Being and Quality of Life for Persons with Parkinson's Disease in Northern Taiwan. JOURNAL OF PARKINSON'S DISEASE 2022; 12:173-184. [PMID: 34690150 DOI: 10.3233/jpd-212764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Parkinson's disease (PD), a degenerative disease with irreversible motor dysfunction, impacts patients' quality of life (QoL). Spirituality can provide a sense of hope and meaning when individuals are faced with adverse life events, such as a diagnosis of PD. However, few studies have examined the relationship between spiritual well-being and QoL for persons with PD. OBJECTIVE To explore the relationships between the disease characteristics, spirituality and QoL for persons with PD, and verify the mediating effects of spirituality on the relationship. METHODS This cross-sectional study recruited patients with PD (n = 110) by convenience sampling from a neurological clinic in northern Taiwan. Variables were measured using the Spirituality Index of Well-Being Chinese version (SIWB-C) and the 39-item Parkinson's disease Quality of Life Questionnaire Chinese version (PDQ-39-C) self-report questionnaires. Descriptive analysis and linear hierarchical regression were conducted to examine the studied variables and explore the mediating effect of spiritual wellbeing. RESULTS Those whose scores were significantly better in PDQ-39 were younger, employed, with shorter disease duration and less severe condition with better functioning on their early stages and lower LEDD; additionally, those who had better quality of life also experienced better spiritual wellbeing than the counterparts. The regression model demonstrated spiritual self-efficacy had mediating effects between disease characteristics and QoL, explaining 69.8%of the variance (adjusted R2 = 65.3%). CONCLUSION The results can be the references for future strategies and interventions, focusing on increasing spiritual self-efficacy and reducing the impact of disease severity to improve QoL for persons with PD.
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Affiliation(s)
- Shu-Fen Chiu
- Department of Neurosurgery, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Chang-Gung Memorial Hospital, Linkou Medical Center, and Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Pei-Kwei Tsay
- Department of Public Health and Parasitology, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chen Chiu
- Graduate Institute of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Dementia Center, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan, Taiwan
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12
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Patient and caregiver outcomes with levodopa-carbidopa intestinal gel in advanced Parkinson’s disease. NPJ Parkinsons Dis 2021; 7:108. [PMID: 34848716 PMCID: PMC8633325 DOI: 10.1038/s41531-021-00246-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/07/2021] [Indexed: 01/02/2023] Open
Abstract
Levodopa-carbidopa intestinal gel (LCIG) has shown to be efficacious in motor and non-motor symptoms (NMS). Nevertheless, studies with patient Quality of Life (QoL) as a primary endpoint are scarce. To assess the effect of LCIG on Advanced Parkinson’s Disease (APD) patients QoL. Secondarily, the impact on motor symptoms and NMS, emotional well-being, treatment satisfaction, and caregiver QoL, stress, disease burden, anxiety, depression, and work impairment were also investigated. In this prospective, 6-month multicenter postmarketing observational study, LCIG was administered to 59 patients with APD. Endpoints were assessed using validated scales and questionnaires. LCIG significantly improved patient QoL (PDQ-39 mean change ± standard deviation from baseline, −12.8 ± 14.6; P < 0.0001), motor symptoms (UPDRS-III in “On,” −6.5 ± 11.8; P = 0.0002), NMS (NMSS, −35.7 ± 31.1; P < 0.0001), mood (Norris/Bond-Lader VAS, −6.6 ± 21.1; P = 0.0297), fatigue (PFS-16, −0.6 ± 1.0; P = 0.0003), depression (BDI-II, −5.1 ± 9.4; P = 0.0002), anxiety (BAI, −6.2 ± 9.6; P < 0.0001), and patient treatment satisfaction (SATMED-Q, 16.1 ± 16.8; P < 0.0001). There were significant correlations between the change from baseline to 6 months between PDQ-39 and UPDRS-IV, NMSS, BAI, BDI-II, AS, and PFS-16 scores, and Norris/Bond-Lader alertness/sedation factor. Caregiver anxiety also improved (Goldberg anxiety scale, −1.1 ± 1.0; P = 0.0234), but the clinical relevance of this finding is questionable. The serious adverse events reported were similar to those previously described for LCIG. In patients with APD, LCIG improves QoL, motor symptoms and NMS, emotional well-being, and satisfaction with the treatment. Improvement in patient QoL is associated with improvements in motor complications, NMS, anxiety, depression, apathy and fatigue. Improvements in patients’ QoL does not correspond with improvements in caregivers’ QoL or burden.
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Lee S. Perceived Health, Psychological Distress, and Subjective Well-Being among Older Adults with Parkinson's Disease: A Cross-Lagged Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12566. [PMID: 34886289 PMCID: PMC8657129 DOI: 10.3390/ijerph182312566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/20/2021] [Accepted: 11/27/2021] [Indexed: 11/16/2022]
Abstract
A growing aging population leads to a gradual increase in the number of patients with Parkinson's disease (PD). This study examines how perceived health, psychological distress, and subjective well-being evolve in older adults with PD. A cross-lagged study design was employed using data from Waves 4 and 6 of the Survey of Health, Aging and Retirement in Europe (SHARE). In total, 421 older adults diagnosed with PD at baseline (46% women; mean age 74.98 ± 9.05 years) were included in the study and were followed up after a four-year lag. Auto-regressive and cross-lagged associations between the measured variables were examined in reciprocal models. Individual differences in perceived health, psychological distress, and subjective well-being were relatively stable over the 4-year lag. A final reciprocal model with significant cross-lagged effects explained the underlying structure of the sample data well: χ2 (49) = 101.876, p < 0.001, CFI = 0.953, NFI = 0.935, RMSEA = 0.050, and AIC = 241.876. Increased difficulties in fulfilling instrumental activities and a lowered level of subjective well-being were particularly noticeable in older adults with PD during the four-year follow-up. Additional attention should be paid to helping older patients with PD cope better with their functional limitations and improve their sense of well-being.
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Affiliation(s)
- Sunwoo Lee
- Faculty of Physical Culture, Palacký University Olomouc, Třída Míru 117, 771 11 Olomouc, Czech Republic
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14
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Ma R, Hou Y, Zhang Y, He M, Gao S, Kaudimba KK, Lin K, Jin L, Liu T, Wang R. The Efficacy of Tai Chi and Stretching Exercises Based on a Smartphone Application for Patients With Parkinson's Disease: A Protocol for a Randomized Controlled Trial. Front Neurol 2021; 12:731606. [PMID: 34777200 PMCID: PMC8581180 DOI: 10.3389/fneur.2021.731606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/24/2021] [Indexed: 01/01/2023] Open
Abstract
Introduction: Parkinson's disease (PD) is a common neurodegenerative disease that seriously impairs patients' quality of life, and increases the burden of patients and caregivers. Both drugs and exercise can alleviate its motor and non-motor symptoms, improving the quality of life for PD patients. Telehealth, an increasingly popular tool, makes rehabilitation accessible at home, overcoming the inconvenience of traffic and scheduling. Care-PD is a phone application designed for rehabilitation training, which provides Tai Chi and stretching exercises through tutorial videos as well as an online evaluation system. In this protocol, we will explore the efficacy of Tai Chi and stretching exercises as a PD rehabilitation therapy based on the smartphone application Care-PD. Methods and Analysis: A double-blind, parallel randomized controlled trial will be conducted in this study. The recruitment, intervention, and evaluation processes will be implemented through the Care-PD application. Persons with PD will fill out questionnaires on Activities of Daily Living (ADL), upload the latest case report, and sign the informed consent form in the application. Afterward, doctors and researchers will screen and enroll 180 participants who will be randomly (1:1:1) assigned to Tai Chi group, stretching exercises group, or control group. The subjects will participate in a 1-h exercise session three times per week for 12 weeks, ending with another 4 weeks of follow-up study. Each exercise session includes 10 min of warm-up, 45 min of exercise, and 5 min of cool-down. The primary outcomes are Motor Aspects of Experiences of Daily Living and the 39-item Parkinson's disease Questionnaire. The secondary outcomes include the 9-item Wearing-Off Questionnaire, the Freezing of Gait Questionnaire, the Caregiver Strain Index, Non-motor Experiences of Daily Living, ADL, and Morse Fall Scale. All assessments will be performed at baseline, week 12 and 16. Discussion: Care-PD integrates subject recruitment, intervention, and evaluation, providing a new perspective on clinical rehabilitation for persons with PD. This study will evaluate the efficacy of Tai Chi and stretching exercises on patients' quality of life and disease progression based on a smartphone application. We aim to provide a new rehabilitation training platform for persons with PD. Ethics and Dissemination: This study was approved by the Scientific Research Ethics Committee (102772020RT132) of Shanghai University of Sport. Data collection begins after the approval of the ethics committee. The participants must sign an informed consent form before enrollment. The results will be published in relevant journals, seminars, and be disseminated among rehabilitation practitioners and patients with PD. Clinical Trial Registration: Chinese Clinical Trial Registry, identifier [ChiCTR2100042096]. Registered on January 13, 2021.
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Affiliation(s)
- Renyan Ma
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yuning Hou
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yiyin Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Muyang He
- Shanghai Medical College, Fudan University, Shanghai, China
| | - Song Gao
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | | | - Kaiqing Lin
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Lingjing Jin
- Department of Neurology, Tongji Hospital, Tongji University, Shanghai, China
| | - Tiemin Liu
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China
| | - Ru Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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15
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Longitudinal risk factors for developing depressive symptoms in Parkinson's disease. J Neurol Sci 2021; 429:117615. [PMID: 34492572 DOI: 10.1016/j.jns.2021.117615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Despite the established importance of identifying depression in Parkinson's disease, our understanding of the factors which place the Parkinson's disease patient at future risk of depression is limited. METHODS Our sample consisted of 874 patients from two longitudinal cohorts, PPMI and PDBP, with median follow-up durations of 7 and 3 years respectively. Risk factors for depressive symptoms at baseline were determined using logistic regression. A Cox regression model was then used to identify baseline factors that predisposed the non-depressed patient to develop depressive symptoms that were sustained for at least one year, while adjusting for antidepressant use and cognitive impairment. Common predictors between the two cohorts were identified with a random-effects meta-analysis. RESULTS We found in our analyses that the majority of baseline non-depressed patients would develop sustained depressive symptoms at least once during the course of the study. Probable REM sleep behavior disorder (pRBD), age, duration of diagnosis, impairment in daily activities, mild constipation, and antidepressant use were among the baseline risk factors for depression in either cohort. Our Cox regression model indicated that pRBD, impairment in daily activities, hyposmia, and mild constipation could serve as longitudinal predictors of sustained depressive symptoms. CONCLUSIONS We identified several potential risk factors to aid physicians in the early detection of depression in Parkinson's disease patients. Our findings also underline the importance of adjusting for multiple covariates when analyzing risk factors for depression.
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16
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Cognitive Reserve, Executive Function, and Memory in Parkinson's Disease. Brain Sci 2021; 11:brainsci11080992. [PMID: 34439609 PMCID: PMC8391924 DOI: 10.3390/brainsci11080992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 11/20/2022] Open
Abstract
Cognitive impairment is acknowledged as a feature of Parkinson’s disease (PD), and the most common cognitive declines are in executive function (EF) and memory. Cognitive reserve (CR) may offer some protection against cognitive dysfunction in PD. The present study used two proxies of CR (years of education, premorbid IQ) to examine the relationship between CR and (i) EF (ii) memory in a large PD sample (n = 334). Two aspects of EF were examined, including verbal fluency and planning skills. Two aspects of verbal memory were examined, including immediate recall and delayed recall. For EF, both CR proxies significantly predicted verbal fluency, but only years of education predicted planning skills. Years of education significantly predicted immediate recall, but premorbid IQ did not. Neither CR proxy predicted delayed recall. These findings suggest that CR, in particular years of education, may contribute to EF and memory function in those with PD. A key finding of this study is the varying contribution of CR proxies to different aspects of the same cognitive domain. The findings indicate that using only one proxy has the potential to be misleading and suggest that when testing the relationship between CR and cognition, studies should include tasks that measure different aspects of the cognitive domain(s) of interest.
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17
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Jung H, Tanaka S, Iwamoto Y, Yamasaki M, Tanaka R. Relationship between Mobility-Related Activities of Daily Living and Health-Related Quality of Life among Healthy Older Adults: A Cross-Sectional Study Using Structural Equation Modeling. Gerontol Geriatr Med 2021; 7:23337214211013166. [PMID: 34026928 PMCID: PMC8120528 DOI: 10.1177/23337214211013166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 02/22/2021] [Accepted: 03/30/2021] [Indexed: 11/15/2022] Open
Abstract
Objective: To develop a conceptual model that confirms whether mobility-related activities of daily living (ADLs) abilities are strongly associated with reduced health-related quality of life (HRQOL) in older adults. Methods: A total of 153 participants (63 men, 90 women) were analyzed. The mobility-related ADL survey from the Ministry of Education, Culture, Sports, Science, and Technology of Japan was used. The Japanese version (v1.2) of the Medical Outcomes Study 36-item Short-Form Health Survey was administered to evaluate HRQOL. Structural equation modeling was performed to test a hypothetical model: mobility-related ADL abilities would influence HRQOL. Results: The chi-square value was not significant (chi-square = 9.463, p = .305), and goodness-of-fit values were high, implying that the model was validated; goodness-of-fit index, 0.981; adjusted goodness-of-fit index, 0.949; comparative fit index, 0.996; and root mean square error of approximation, 0.035. Results showed that mobility-related ADL abilities influenced the physical health including physical function and general health in HRQOL. Conclusions: This study developed the conceptual model confirming the influence of mobility-related ADL abilities especially on physical health. Further intervention studies on instructions/training for physical activity of healthy older adults should assess this causal relationship.
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Affiliation(s)
- Hungu Jung
- Hiroshima University, Higashi-Hiroshima City, Japan.,Hiroshima Bunka Gakuen University, Akigunsakacho, Japan
| | | | - Yuji Iwamoto
- Hiroshima University, Higashi-Hiroshima City, Japan
| | | | - Ryo Tanaka
- Hiroshima University, Higashi-Hiroshima City, Japan
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18
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Jansen AE, Koop MM, Rosenfeldt AB, Alberts JL. High intensity aerobic exercise improves bimanual coordination of grasping forces in Parkinson's disease. Parkinsonism Relat Disord 2021; 87:13-19. [PMID: 33932704 DOI: 10.1016/j.parkreldis.2021.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 11/03/2020] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Parkinson's disease (PD) disrupts the control and coordination of grasping forces, likely due to a disruption in basal ganglia circuitry and diminished activity within the supplementary motor area (SMA). High intensity aerobic exercise has been shown to enhance connectivity between basal ganglia nuclei and cortical areas, including the SMA. The aim of this project was to determine the effects of high intensity lower extremity exercise on motor control patterns underlying a manual dexterity task. METHODS PD participants completed eight weeks of high intensity aerobic exercise under forced or voluntary exercise (FE or VE) modalities. Grasping forces for each limb were quantified during a functional bimanual dexterity task. Data were collected while OFF antiparkinsonian medication at baseline, end of treatment (EOT), and eight weeks after exercise cessation (EOT+8). RESULTS Eight weeks of high intensity exercise improved MDS-UPDRS Motor III clinical ratings by more than 4 points (~15%) for the FE and VE groups. Time to complete the task decreased nearly 30% across both groups as well. The control and coordination of grasping forces, simultaneity of force initiation, and rate of grip and load force exhibited significant improvements following exercise. In general, improvements in biomechanical outcomes were sustained following exercise cessation. CONCLUSION High intensity aerobic exercise, achieved via a forced or voluntary mode, improved PD symptoms and bimanual dexterity. Sustained improvement of upper extremity motor control following exercise cessation indicates high intensity exercise enhances CNS functioning and suggests exercise may be a candidate for altering PD progression.
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Affiliation(s)
- A Elizabeth Jansen
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Mandy Miller Koop
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Anson B Rosenfeldt
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Jay L Alberts
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA; Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA.
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Khedr EM, Abdelrahman AA, Elserogy Y, Zaki AF, Gamea A. Depression and anxiety among patients with Parkinson’s disease: frequency, risk factors, and impact on quality of life. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00253-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Depression and anxiety are non-motor symptoms of Parkinson’s disease (PD) that are often overlooked and underrated. This study aimed to highlight the frequency and risk factors of depression and anxiety among subjects with PD.
Methods
Sixty-four patients with PD who were diagnosed according to United Kingdom Parkinson’s Disease Society (UKPDS) Brain Bank Criteria and 50 sex- and age-matched healthy control subjects are evaluated for depression and anxiety. PD severity and staging were assessed using Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr scale. Depression and anxiety were diagnosed using DSM-IV TR criteria and scored using Hamilton Depression and Hamilton Anxiety Rating Scales (HAM-D and HAM-A). The World Health Organization Quality of Life (WHOQOL)-BREF was used to assess impact of depression and anxiety on quality of life.
Results
31.25% of patients with PD had depression while 40.6% of patients had anxiety disorder. Depression was higher in females and patients with history of depression and low socioeconomic status (SES). Anxiety was common in young patients and those who had history of anxiety. Overlap between depression and anxiety was recorded in 23.4%. Total UPDRS and Hoehn and Yahr scale accounted for 33.4% of variance for depression. Total UPDRS and earlier age of onset accounted for 39% of variance for anxiety. Advanced disease stage and severity were independent predictors for depression while disease severity and younger age of onset were the main predictors for anxiety. Depression and anxiety have a negative impact on the overall quality of life of PD patients especially on physical and psychosocial domains.
Conclusion
Depression and anxiety are relatively common in PD. Female gender, low SES, and history of depression were the main risk factors for developing depression. Young age and history of anxiety were risk factors for anxiety. Both had negative impact on quality of life.
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20
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Depression in Parkinson's disease: Perspectives from an Australian cohort. J Affect Disord 2020; 277:1038-1044. [PMID: 33065812 DOI: 10.1016/j.jad.2020.09.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/24/2020] [Accepted: 09/08/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Depression is often an under-recognised feature of Parkinson's disease (PD). It is detrimental to physical and interpersonal functioning, negatively impacting a patient's clinical management, quality of life and well-being. We aimed to identify clinical predictors and management implications of depression in Australian PD patients. METHODS 103 PD and 81 Healthy Control (HC) subjects were evaluated using the Beck Depression Inventory (BDI) and other validated PD motor and non-motor symptom (NMS) tools. RESULTS Nearly twice as many PD patients were depressed, (38.9% vs 20.1%, p = 0.009), with a corresponding increase in depression severity on the BDI (11.9; standard deviation (SD) 8.8 vs 5.2; SD 5.5, p<0.001), and an odds ratio of 2.4 (95% confidence interval 1.2 - 4.7). Employment appeared to be a relative protective factor for depression, whilst patients requiring support services seemed to be more vulnerable to depression. Rapid Eye Movement Sleep Behaviour Disorder, dyskinesias, impulse control disorder, higher daily levodopa equivalent dose, increased motor severity, as well as catechol-O-methyltransferase inhibitor and amantadine use, all showed associations with depression (p<0.05). Chronic pain, decreased physical activity, constipation and upper gastrointestinal dysfunction presented with an apparent increase in risk for developing depression and increased depression severity. Other NMS were also found to be associated with PD-related depression. LIMITATIONS Potential selection bias of self-reporting data collection from specialist PD clinics in a single metropolitan area. CONCLUSION Our findings provide novel insight into the prevalence of depression in PD, possible contributory factors and future treatment strategies targeting depression in PD.
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21
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Byeon H. Development of a depression in Parkinson's disease prediction model using machine learning. World J Psychiatry 2020; 10:234-244. [PMID: 33134114 PMCID: PMC7582129 DOI: 10.5498/wjp.v10.i10.234] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 09/01/2020] [Accepted: 09/22/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It is important to diagnose depression in Parkinson’s disease (DPD) as soon as possible and identify the predictors of depression to improve quality of life in Parkinson’s disease (PD) patients.
AIM To develop a model for predicting DPD based on the support vector machine, while considering sociodemographic factors, health habits, Parkinson's symptoms, sleep behavior disorders, and neuropsychiatric indicators as predictors and provide baseline data for identifying DPD.
METHODS This study analyzed 223 of 335 patients who were 60 years or older with PD. Depression was measured using the 30 items of the Geriatric Depression Scale, and the explanatory variables included PD-related motor signs, rapid eye movement sleep behavior disorders, and neuropsychological tests. The support vector machine was used to develop a DPD prediction model.
RESULTS When the effects of PD motor symptoms were compared using “functional weight”, late motor complications (occurrence of levodopa-induced dyskinesia) were the most influential risk factors for Parkinson's symptoms.
CONCLUSION It is necessary to develop customized screening tests that can detect DPD in the early stage and continuously monitor high-risk groups based on the factors related to DPD derived from this predictive model in order to maintain the emotional health of PD patients.
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Affiliation(s)
- Haewon Byeon
- Major in Medical Big Data, College of AI Convergence, Inje University, Gimhae 50834, Gyeonsangnamdo, South Korea
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22
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Koutsouras GW, Levine K, Duroseau N, Ciraco C, Chan V, Pergament K, Chan T, Mancini JD, Leder AN, Krishnamachari B. Effects of depression and exercise on health-related quality of life in patients with Parkinson's disease. Chronic Illn 2020; 16:190-200. [PMID: 30185064 DOI: 10.1177/1742395318796166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES There is limited literature describing the effect exercise may have on depression and an individual's health-related quality of life (HRQoL) in Parkinson's Disease (PD). We aim to quantify this effect. METHODS A cross-sectional questionnaire was administered to 60 PD subjects. The Parkinson's Disease Questionnaire-39 (PDQ-39) summary index and the Geriatric Depression Scale-30 were used to quantify HRQoL and depression, respectively. Data were obtained on exercise habits. ANOVA and multivariate linear regression analysis were used to calculate mean differences in HRQoL. RESULTS Depression was consistently related to HRQoL (p < 0.05). Of those who exercised as an adult before PD diagnosis, 49.02% (n = 25) reported depression as compared to 88.89% (n = 8) of those who did not report adult exercise (p = 0.03). Those who exercised frequently as an adult prior to PD diagnosis had a better PDQ-39 Cognitive Index (p = 0.03). Those who were not depressed and were currently exercising had a significantly higher HRQoL than those who were depressed and did not exercise (p < 0.01). DISCUSSION Exercising and depression may interact to affect HRQoL. Thus, coordination of mental health evaluation and exercise regimens in persons with PD may improve HRQoL.
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Affiliation(s)
- George W Koutsouras
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Kimberly Levine
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Nathalie Duroseau
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Christina Ciraco
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Vivian Chan
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Kathleen Pergament
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Thomas Chan
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Jayme D Mancini
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Adena N Leder
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Bhuma Krishnamachari
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
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Gómez-Cuervo C, Díaz-Pedroche C, Pérez-Jacoiste Asín A, Lalueza A, Díaz-Simón R, Lumbreras C. Quality of Life After a Venous Thrombosis in Elderly Patients: Results From a Prospective Spanish Cohort. Arch Bronconeumol 2020; 56:187-188. [DOI: 10.1016/j.arbres.2019.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/30/2019] [Accepted: 09/18/2019] [Indexed: 11/30/2022]
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Sklerov M, Shih CH, Browner N, Palma JA, Styner M, Dayan E. Longitudinal change in autonomic symptoms predicts activities of daily living and depression in Parkinson’s disease. Clin Auton Res 2020; 30:223-230. [DOI: 10.1007/s10286-020-00672-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/07/2020] [Indexed: 10/25/2022]
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25
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Tidman M, Skotzke E. Effects of a community-based exercise program on mobility, balance, cognition, sleep, activities of daily living, and quality of life in PD: a pilot study. Neurodegener Dis Manag 2020; 10:27-39. [PMID: 32031050 DOI: 10.2217/nmt-2019-0027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Aim: The primary objective of the study was to evaluate the effects of a community-based exercise program for adults with Parkinson's disease (PD). Patients & methods: This one-group pretest and post-test design involved 22 participants with PD who participated in two to three exercise sessions per week for 8 weeks. Outcomes assessed for statistical significance included balance, mobility, cognition, activities of daily living, sleep and quality of life. Results: Although exercise is positively correlated with improvements in function, this short-duration study did not demonstrate this. Qualitative themes revealed an increase in self-perceived socialization, coordination and motivation to continue exercise. Conclusion: This community-based exercise study showed improvements in socialization, self-reported coordination and motivation to exercise. Further research is needed to assess community exercise interventions for PD.
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Affiliation(s)
- Melanie Tidman
- Department of Health Sciences, College of Graduate Health Studies, A.T. Still University, Mesa, AZ, USA
| | - Erin Skotzke
- Department of Occupational Therapy, Nova Southeastern University, Fort Lauderdale, FL, USA
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26
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Sperens M, Georgiev D, Eriksson Domellöf M, Forsgren L, Hamberg K, Hariz G. Activities of daily living in Parkinson's disease: Time/gender perspective. Acta Neurol Scand 2020; 141:168-176. [PMID: 31693751 DOI: 10.1111/ane.13189] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/22/2019] [Accepted: 10/31/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The objectives of this study were to explore the changes in the activities of daily living (ADL) in persons with Parkinson's disease (pwPD) over time and to investigate possible differences in ADL performance between men and women with PD. MATERIALS & METHODS One hundred twenty-nine persons (76 men) with a clinically established PD self-assessed their ADL performance from the time of diagnosis up to 8 years follow-up using the ADL taxonomy. Other demographic and clinical data (motor state, cognition, depression) were also collected and subjected to further analysis. RESULTS Nine of 12 domains in the ADL taxonomy showed a change over time (Eating and Drinking [P = .009], Mobility [P < .001], Toilet activities [P = .031], Dressing [P < .001], Personal hygiene [P < .001], Communication [P < .001], Cooking [P = .001], Shopping [P < .001] and Cleaning [P < .001]). In addition to time, two domains, (Shopping [P = .007] and Cleaning [P = .027]) also showed an effect of gender with worse scores in women. The nine ADL domains showing effect of time, showed temporary improvement at 12 months follow-up, most probably due to dopaminergic medication. All nine domains deteriorated at later follow-up. CONCLUSIONS As expected, there was deterioration in self-assessed performance in the majority od ADL domains over time. Women assessed their ADLs worse in two domains (Shopping and Cleaning) probably reflecting a general gender-related activity pattern rather than being a PD-specific finding.
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Affiliation(s)
- Maria Sperens
- Department of Community Medicine and Rehabilitation Umeå University Umeå Sweden
| | - Dejan Georgiev
- Department of Community Medicine and Rehabilitation Umeå University Umeå Sweden
- Department of Neurology University Medical Centre Ljubljana Ljubljana Slovenia
- Faculty of Computer Sciences and Informatics University of Ljubljana Ljubljana Slovenia
- Faculty of Medicine University of Ljubljana Ljubljana Slovenia
| | | | - Lars Forsgren
- Department of Pharmacology and Clinical Neuroscience Umeå University Umeå Sweden
| | - Katarina Hamberg
- Department of Public Health and Clinical Medicine Family Medicine Umeå University Umeå Sweden
| | - Gun‐Marie Hariz
- Department of Community Medicine and Rehabilitation Umeå University Umeå Sweden
- Department of Pharmacology and Clinical Neuroscience Umeå University Umeå Sweden
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Suicidal risk and demoralization in Parkinson disease. J Neurol 2019; 267:966-974. [DOI: 10.1007/s00415-019-09632-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/07/2019] [Accepted: 11/09/2019] [Indexed: 11/26/2022]
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Vaartio-Rajalin H, Rauhala A, Fagerström L. Person-centered home-based rehabilitation for persons with Parkinson's disease: A scoping review. Int J Nurs Stud 2019; 99:103395. [PMID: 31525645 DOI: 10.1016/j.ijnurstu.2019.103395] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Due to vague, initial symptoms, persons with Parkinson's disease (PD) usually receive a definitive diagnosis after a prolonged period of time. At the time of diagnosis, they have already experienced limitations in activities of daily living and quality of life and are thus in need of immediate rehabilitation. OBJECTIVE To describe the existing knowledge on the rehabilitation of persons with PD suitable to a home environment and to describe the person-centeredness, interprofessionality and clinical effectiveness of existing rehabilitation activities. SOURCES OF EVIDENCE 67 full-text papers from the EBSCO, CINAHL, Medline, Google and Google Scholar databases, published in English, Swedish or Finnish between January 2010 and October 2018, were charted (type of rehabilitation, sample, instrumentation, reported effects) and summarized. RESULTS Rehabilitation through physical activities still appears to be the most common form of rehabilitation, varying from walking to individually tailored exercise programs. The majority of physical rehabilitation activities were conducted outside the home even though they were suitable for a home setting. Physical activities not only improved several physical outcomes but also quality of life, well-being and activities of daily living functions, especially when digital devices were used. Cognitive and psychosocial rehabilitation were much less researched but seen to be an emerging area of research. The focus of rehabilitation seems to lie on persons with PD, not their near-ones. The majority of interventions were planned without discussing in advance with the persons with PD about their preferences, needs or values. Very few interventions were individually tailored or conducted in a home setting, and many studies included patient-recorded outcome measures, but only as secondary to clinical measures. Only a few studies focused on an interprofessional approach to PD rehabilitation, despite the approach being found effective in regard to quality of life for persons with PD. CONCLUSIONS There appears to be a focus on physical outcomes and symptom management in the rehabilitation of persons with PD, even though cognitive and psychosocial well-being are often explored as secondary outcomes. Very few rehabilitation interventions were planned with persons or conducted in a home setting, and no interventions were seen that included near-ones. The majority of interventions were planned without the involvement of persons with PD. Still, many of the studies included patient-recorded outcome measures. Digital devices that assist in physical rehabilitation and an interprofessional approach to rehabilitation yield positive clinical outcomes, which in turn promotes a person-centered and holistic approach to rehabilitation.
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Affiliation(s)
- Heli Vaartio-Rajalin
- Faculty of Pedagogy and Welfare Studies, Department of Health Science, Åbo Akademi University, Strandgatan 2, 65100, Vasa, Finland; Nursing Program, Novia University of Applied Sciences, Henriksgatan 7, 20500, Åbo, Finland.
| | - Auvo Rauhala
- Faculty of Pedagogy and Welfare Studies, Department of Health Science, Åbo Akademi University, Strandgatan 2, 65100, Vasa, Finland; Vaasa Central Hospital, Sandviksgatan 2-4, 65100, Vasa, Finland
| | - Lisbeth Fagerström
- Faculty of Pedagogy and Welfare Studies, Department of Health Science, Åbo Akademi University, Strandgatan 2, 65100, Vasa, Finland; Faculty of Health and Social Sciences, University of South-Eastern Norway, PO 235, 3603, Kongsberg, Norway
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Ryan M, Eatmon CV, Slevin JT. Drug treatment strategies for depression in Parkinson disease. Expert Opin Pharmacother 2019; 20:1351-1363. [DOI: 10.1080/14656566.2019.1612877] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Melody Ryan
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Courtney V. Eatmon
- Mental Health Clinical Pharmacy Specialist, Lexington Veterans Affairs Healthcare System, Lexington, KY, USA
| | - John T. Slevin
- Departments of Neurology and Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY, USA
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Sociodemographic Factors Affecting the Disease Acceptance and the Quality of Life in Patients With Parkinson's Disease: A Preliminary Study. Rehabil Nurs 2019; 44:35-46. [PMID: 29782477 DOI: 10.1097/rnj.0000000000000149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Parkinson's disease (PD) significantly affects functioning of patients, thereby lowering their quality of life. The aim of this study was to evaluate the influence of sociodemographic variables on illness acceptance and quality of life in patients with idiopathic PD. DESIGN This is a cross-sectional research study. METHODS The study was conducted with 50 patients with PD. The diagnostic survey method was applied for the purposes of this study with the use of the Parkinson's Disease Questionnaire, the Acceptance of Illness Scale, and a study-specific demographic questionnaire that included questions about sociodemographic data. Multivariable logistic regression was derived to define independent predictors of quality of life. FINDINGS Men assessed quality of life in the bodily discomfort domain as significantly worse than women (p = .0214). Age negatively and significantly affected the assessment of quality of life in particular domains. Professionally active respondents significantly more often accepted their disease than others (p = .0070). CONCLUSIONS AND CLINICAL RELEVANCE Being professionally active, living in urban areas, and having higher education and higher financial status increase subjective assessment of quality of life in patients with PD. Knowing the impact of sociodemographic variables on quality of life allows rehabilitation nurses to plan nursing and rehabilitation activities more effectively and in line with the capacity of a patient and caregivers.
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Ritter VC, Bonsaksen T. Improvement in quality of life following a multidisciplinary rehabilitation program for patients with Parkinson's disease. J Multidiscip Healthc 2019; 12:219-227. [PMID: 31114215 PMCID: PMC6497500 DOI: 10.2147/jmdh.s202827] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 02/22/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Parkinson's disease follows a chronic course, and therefore quality of life is important to assess in relation to rehabilitation programs for persons with the disease. Aim: To examine whether a brief rehabilitation program can promote positive changes in functional status, general self-efficacy, and quality of life and to examine factors associated with changes in quality of life. Methods: Patients with Parkinson's disease (n=83) completed the General Self-Efficacy Scale and the Parkinson's Disease Questionnaire at the beginning of a rehabilitation program and at three weeks follow-up. Within-person changes were analyzed with paired t-tests. A hierarchical linear regression was conducted to assess the independent associations between the independent variables and changes in quality of life during the three weeks program, while adjusting for the covariance between the independent variables. Results: Patients reported higher functional status (d=0.37, p<0.001), general self-efficacy (d =0.28, p<0.01), and quality of life (d=0.32, p<0.001) at three weeks follow-up, compared to their baseline scores. The regression analysis showed that having a better initial functional status (β =-0.26, p<0.05) and lower quality of life (β =0.51, p<0.001) were associated with more improvements in quality of life. Conclusion: The study suggests that actual functioning in persons with Parkinson's disease is a better predictor of improved quality of life than self-efficacy beliefs and that those who have lower levels of initial quality of life benefit more from rehabilitation.
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Affiliation(s)
- Victoria C Ritter
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet – Oslo Metropolitan University, Oslo, Norway
| | - Tore Bonsaksen
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet – Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
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Activities of Daily Living and Their Relationship to Health-Related Quality of Life in Patients with Parkinson Disease After Subthalamic Nucleus Deep Brain Stimulation. World Neurosurg 2019; 125:e552-e562. [PMID: 30716489 DOI: 10.1016/j.wneu.2019.01.132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can reduce motor symptoms in patients with Parkinson disease (PD) and improve their health-related quality of life (HRQoL). The effect of STN DBS on activities of daily living (ADL), an important component of quality of life, is poorly understood. We aimed to investigate effects of STN DBS on HRQoL and ADL in patients with PD. METHODS HRQoL and ADL were assessed using the following disease-specific and generic questionnaires at baseline and 3, 6, and 12 months after surgery: the Parkinson's Disease Questionnaire 39 (PDQ-39), the Short-Form 36 health survey questionnaire, the World Health Organization Quality of Life Scale-Brief version, the Unified Parkinson's Disease Rating Scale part II, the ADL scale, and the Instrumental Activities of Daily Living scale. RESULTS We reported significant early improvements (3 months) in the HRQoL and ADL, and these benefits increased over time (6 months); however, further improvement between 6 and 12 months was nonsignificant. Two PDQ-39 subdomains (social support and communications) and a Short-Form 36 health survey questionnaire subdomain (social functioning) showed declines after surgery. Changes in the Instrumental Activities of Daily Living scale were significantly correlated with changes in the PDQ-39 summary index and other PDQ-39 subdomains, including mobility, emotional well-being, social support, and cognition, at all follow-up points. CONCLUSIONS STN DBS caused a marked improvement in HRQoL at 3 and 6 months; however, HRQoL remained stable at the 12-month postoperative follow-up. Moreover, we have shown a significant correlation between ADL performance and HRQoL after STN DBS.
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Morgan R, DiZazzo-Miller R. The Occupation-Based Intervention of Bathing: Cases in Home Health Care. Occup Ther Health Care 2019; 32:306-318. [PMID: 30616414 DOI: 10.1080/07380577.2018.1504368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although bathing skills can be an indicator of long term placement, documentation of occupational therapists doing bathing as an occupation-based intervention is limited. Five clients were referred to a hospital-based home health agency with various diagnoses and at different levels of functioning. Each client was assessed at admission and discharge using the Outcomes and Assessment Information Set and the occupational therapists used the Activities of daily living (ADL) of bathing as the intervention based on client centered expressed needs. Findings reveal a statistically significant change in individuals pre- and post-assessment of bathing (Z = -2.032, p = .042) supporting occupation-based interventions, specifically bathing, should be further researched as a means of significantly improving the functional status of clients.
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Affiliation(s)
- Rod Morgan
- a DrOT, OTR/L - Occupational Therapist at Pikeville Medical Center , Pikeville , KY , USA
| | - Rosanne DiZazzo-Miller
- b DrOT, PhD, OTRL, CDP, FMiOTA - Associate Professor in the Occupational Therapy Program, Wayne State University , Detroit , MI , USA
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Skorvanek M, Martinez-Martin P, Kovacs N, Zezula I, Rodriguez-Violante M, Corvol JC, Taba P, Seppi K, Levin O, Schrag A, Aviles-Olmos I, Alvarez-Sanchez M, Arakaki T, Aschermann Z, Benchetrit E, Benoit C, Bergareche-Yarza A, Cervantes-Arriaga A, Chade A, Cormier F, Datieva V, Gallagher DA, Garretto N, Gdovinova Z, Gershanik O, Grofik M, Han V, Kadastik-Eerme L, Kurtis MM, Mangone G, Martinez-Castrillo JC, Mendoza-Rodriguez A, Minar M, Moore HP, Muldmaa M, Mueller C, Pinter B, Poewe W, Rallmann K, Reiter E, Rodriguez-Blazquez C, Singer C, Valkovic P, Goetz CG, Stebbins GT. Relationship between the MDS-UPDRS and Quality of Life: A large multicenter study of 3206 patients. Parkinsonism Relat Disord 2018; 52:83-89. [PMID: 29625875 DOI: 10.1016/j.parkreldis.2018.03.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/08/2018] [Accepted: 03/27/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND The relationship between Health-Related Quality of Life (HRQoL) and MDS-UPDRS has not been fully studied so far. The aim of this study was to evaluate the relationship between all MDS-UPDRS components and HRQoL in a representative international cohort of PD patients. METHODS We collected demographic and disease-related data as well as MDS-UPDRS and PDQ8 scales. Data were analyzed using correlations between PDQ8 and all MDS-UPDRS items, subsequently two hierarchical multiple regressions were performed, first between the scores of the MDS-UPDRS Parts and PDQ8 and second between individual items from those Parts demonstrating significant relationship to PDQ8 scores in the first regression. LASSO regression analyses were performed to evaluate the relationship between PDQ8 and all individual MDS-UPDRS items. RESULTS A total of 3206 PD patients were included in the study. In the first regression analysis, PDQ8 was significantly related to MDS-UPDRS parts I and II, but not to III and IV. In the second regression model, significant contributions to PDQ8 were found for Part I items Fatigue, Pain, Depressed mood, Apathy; and Part II items Dressing, Doing hobbies, Freezing, Speech and Tremor. In the LASSO analysis, six Part I, seven Part II, three Part III and one Part IV items contributed to PDQ8 scores. The five items most significantly related to the model were Depressed mood, Dressing, Apathy, Pain and Fatigue. CONCLUSIONS This is so far the largest study related to HRQoL issues in PD. Restrictions in activities of daily living and non-motor symptoms significantly contribute to HRQoL in PD.
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Affiliation(s)
- Matej Skorvanek
- Dept. of Neurology, P. J. Safarik University, Kosice, Slovak Republic; Dept. of Neurology, University Hospital L. Pasteur, Kosice, Slovak Republic; Centre of Experimental, Translational and Clinical Medicine, Technology and Innovation Park, P. J. Safarik University, Kosice, Slovak Republic.
| | - Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | - Norbert Kovacs
- Dept. of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Ivan Zezula
- Inst. of Mathematics, P. J. Safarik University, Kosice, Slovak Republic
| | | | - Jean-Christophe Corvol
- Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS_1127, CIC_1422, CNRS UMR_7225, AP-HP, ICM, Hôpital Pitié-Salpêtrière, Département des maladies du système nerveux, F-75013, Paris, France
| | - Pille Taba
- Dept. of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia
| | - Klaus Seppi
- Dep. of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Oleg Levin
- Dept. of Neurology, Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | - Anette Schrag
- Dept. of Clinical Neuroscience, UCL Institute of Neurology, London, UK
| | - Iciar Aviles-Olmos
- Sobell Department of Motor Neuroscience, UCL Institute of Neurology, London, UK
| | | | - Tomoko Arakaki
- Dept. of Neurology, Hospital Ramos Mejia, Buenos Aires, Argentina
| | | | - Eve Benchetrit
- Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS_1127, CIC_1422, CNRS UMR_7225, AP-HP, ICM, Hôpital Pitié-Salpêtrière, Département des maladies du système nerveux, F-75013, Paris, France
| | - Charline Benoit
- Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS_1127, CIC_1422, CNRS UMR_7225, AP-HP, ICM, Hôpital Pitié-Salpêtrière, Département des maladies du système nerveux, F-75013, Paris, France
| | | | - Amin Cervantes-Arriaga
- Clinical Neurodegenerative Diseases Research Unit, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Anabel Chade
- Movement Disorders Unit, Institute of Neurosciences, Favaloro University, INECO, Buenos Aires, Argentina
| | - Florence Cormier
- Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS_1127, CIC_1422, CNRS UMR_7225, AP-HP, ICM, Hôpital Pitié-Salpêtrière, Département des maladies du système nerveux, F-75013, Paris, France
| | - Veronika Datieva
- Dept. of Neurology, Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | | | - Nelida Garretto
- Dept. of Neurology, Hospital Ramos Mejia, Buenos Aires, Argentina
| | - Zuzana Gdovinova
- Dept. of Neurology, P. J. Safarik University, Kosice, Slovak Republic; Dept. of Neurology, University Hospital L. Pasteur, Kosice, Slovak Republic
| | - Oscar Gershanik
- Movement Disorders Unit, Institute of Neurosciences, Favaloro University, INECO, Buenos Aires, Argentina
| | - Milan Grofik
- Dept. of Neurology, Comenius University, Martin, Slovak Republic
| | - Vladimir Han
- Dept. of Neurology, P. J. Safarik University, Kosice, Slovak Republic; Dept. of Neurology, University Hospital L. Pasteur, Kosice, Slovak Republic
| | | | - Monica M Kurtis
- Movement Disorders Program, Dept. of Neurology, Hospital Ruber Internacional, Madrid, Spain
| | - Graziella Mangone
- Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS_1127, CIC_1422, CNRS UMR_7225, AP-HP, ICM, Hôpital Pitié-Salpêtrière, Département des maladies du système nerveux, F-75013, Paris, France
| | | | | | - Michal Minar
- 2nd Dept. of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - Henry P Moore
- Dept. of Neurology, University of Miami, Miami, FL, USA
| | - Mari Muldmaa
- Dept. of Neurology, North Estonian Medical Center, Tallinn, Estonia
| | - Christoph Mueller
- Dep. of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Bernadette Pinter
- Dep. of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Werner Poewe
- Dep. of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Karin Rallmann
- Dept. of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia
| | - Eva Reiter
- Dep. of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Carlos Singer
- Dept. of Neurology, University of Miami, Miami, FL, USA
| | - Peter Valkovic
- 2nd Dept. of Neurology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - Christopher G Goetz
- Dept. of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Glenn T Stebbins
- Dept. of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Cognitive Training and Transcranial Direct Current Stimulation for Mild Cognitive Impairment in Parkinson's Disease: A Randomized Controlled Trial. PARKINSONS DISEASE 2018; 2018:4318475. [PMID: 29780572 PMCID: PMC5892209 DOI: 10.1155/2018/4318475] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/08/2018] [Accepted: 01/28/2018] [Indexed: 01/28/2023]
Abstract
This study examined whether standard cognitive training, tailored cognitive training, transcranial direct current stimulation (tDCS), standard cognitive training + tDCS, or tailored cognitive training + tDCS improved cognitive function and functional outcomes in participants with PD and mild cognitive impairment (PD-MCI). Forty-two participants with PD-MCI were randomized to one of six groups: (1) standard cognitive training, (2) tailored cognitive training, (3) tDCS, (4) standard cognitive training + tDCS, (5) tailored cognitive training + tDCS, or (6) a control group. Interventions lasted 4 weeks, with cognitive and functional outcomes measured at baseline, post-intervention, and follow-up. The trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR: 12614001039673). While controlling for moderator variables, Generalized Linear Mixed Models (GLMMs) showed that when compared to the control group, the intervention groups demonstrated variable statistically significant improvements across executive function, attention/working memory, memory, language, activities of daily living (ADL), and quality of life (QOL; Hedge's g range = 0.01 to 1.75). More outcomes improved for the groups that received standard or tailored cognitive training combined with tDCS. Participants with PD-MCI receiving cognitive training (standard or tailored) or tDCS demonstrated significant improvements on cognitive and functional outcomes, and combining these interventions provided greater therapeutic effects.
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Ghai S, Ghai I, Schmitz G, Effenberg AO. Effect of rhythmic auditory cueing on parkinsonian gait: A systematic review and meta-analysis. Sci Rep 2018; 8:506. [PMID: 29323122 PMCID: PMC5764963 DOI: 10.1038/s41598-017-16232-5] [Citation(s) in RCA: 143] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/06/2017] [Indexed: 01/11/2023] Open
Abstract
The use of rhythmic auditory cueing to enhance gait performance in parkinsonian patients' is an emerging area of interest. Different theories and underlying neurophysiological mechanisms have been suggested for ascertaining the enhancement in motor performance. However, a consensus as to its effects based on characteristics of effective stimuli, and training dosage is still not reached. A systematic review and meta-analysis was carried out to analyze the effects of different auditory feedbacks on gait and postural performance in patients affected by Parkinson's disease. Systematic identification of published literature was performed adhering to PRISMA guidelines, from inception until May 2017, on online databases; Web of science, PEDro, EBSCO, MEDLINE, Cochrane, EMBASE and PROQUEST. Of 4204 records, 50 studies, involving 1892 participants met our inclusion criteria. The analysis revealed an overall positive effect on gait velocity, stride length, and a negative effect on cadence with application of auditory cueing. Neurophysiological mechanisms, training dosage, effects of higher information processing constraints, and use of cueing as an adjunct with medications are thoroughly discussed. This present review bridges the gaps in literature by suggesting application of rhythmic auditory cueing in conventional rehabilitation approaches to enhance motor performance and quality of life in the parkinsonian community.
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Affiliation(s)
- Shashank Ghai
- Institute of Sports Science, Leibniz University Hannover, Hannover, Germany.
| | - Ishan Ghai
- School of Life Sciences, Jacobs University Bremen, Bremen, Germany
| | - Gerd Schmitz
- Institute of Sports Science, Leibniz University Hannover, Hannover, Germany
| | - Alfred O Effenberg
- Institute of Sports Science, Leibniz University Hannover, Hannover, Germany
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Lyu W, Wolinsky FD. The Onset of ADL Difficulties and Changes in Health-Related Quality of Life. Health Qual Life Outcomes 2017; 15:217. [PMID: 29110672 PMCID: PMC5674843 DOI: 10.1186/s12955-017-0792-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 10/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effect of the onset of difficulties with activities of daily living (ADLs) on the health-related quality of life (HRQoL) of older adults is not well understood. We identified strong longitudinal associations between ADL onset and HRQoL changes for older adults in Medicare Advantage Organizations (MAOs). METHODS We analyzed 473,282 age-eligible MAO beneficiaries in the 2008-2013 Medicare Health Outcomes Surveys (M-HOS) who reported no ADL difficulties at baseline and completed their two-year follow-ups in 2010-2015. The four HRQoL measures were the physical and mental health component scores (PCS and MCS) from the SF-12V, and the CDC's counts of physically unhealthy and mentally unhealthy days (PUD and MUD) in the past month. Ordinary least squares (OLS) and zero-inflated negative binomial regressions were used. RESULTS The onset of difficulty/inability in bathing, dressing, eating, getting in/out of chairs, walking, and using the toilet significantly reduced PCS scores by 10.84, 11.29, 9.18, 8.98, 9.49 and 10.67 points, and MCS scores by 7.93, 8.72, 10.13, 5.34, 4.37 and 9.00 points, respectively. The onset of difficulty/inability in bathing, dressing, eating, getting in/out of chairs, walking, and using the toilet increased PUD days by 6.24, 6.83, 6.34, 4.93, 4.96 and 6.72 days, and MUD days by 3.00, 3.19, 3.54, 2.26, 2.07 and 3.27 days, respectively. CONCLUSIONS There is robust evidence that the onset of ADL difficulties/inabilities significantly and substantially reduced age-eligible MAO beneficiaries' HRQoL. Prevention strategies focused on ADLs would benefit the performance of MAOs.
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Affiliation(s)
- Wei Lyu
- Department of Health Management and Policy, University of Iowa College of Public Health, 145 N. Riverside Dr., 100 College of Public Health Bldg., Room N269, Iowa City, Iowa, 52242-2007, USA.
| | - Fredric D Wolinsky
- Department of Health Management and Policy, University of Iowa College of Public Health, 145 N. Riverside Dr., 100 College of Public Health Bldg., Room N269, Iowa City, Iowa, 52242-2007, USA.,Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.,University of Iowa College of Nursing, Iowa City, IA, USA
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Psychometric Evaluation of the Parkinson's Disease Activities of Daily Living Scale. PARKINSONS DISEASE 2017; 2017:4151738. [PMID: 29147597 PMCID: PMC5632893 DOI: 10.1155/2017/4151738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 07/22/2017] [Accepted: 08/17/2017] [Indexed: 11/29/2022]
Abstract
Objective To evaluate a set of psychometric properties (i.e., data completeness, targeting, and external construct validity) of the Parkinson's disease Activities of Daily Living Scale (PADLS) in people with Parkinson's disease (PD). Specific attention was paid to the association between PADLS and PD severity, according to the Hoehn & Yahr (H&Y) staging. Methods The sample included 251 persons with PD (mean age 70 [SD 9] years). Data collection comprised a self-administered postal survey, structured interviews, and clinical assessments at home visits. Results Data completeness was 99.6% and the mean PADLS score was 2.1. Floor and ceiling effects were 22% and 2%, respectively. PADLS scores were more strongly associated (rs > 0.5) with perceived functional independence, ADL dependency, walking difficulties, and self-rated PD severity than with variables such as PD duration and cognitive function (rs < 0.5). PADLS scores differed across H&Y stages (Kruskal-Wallis test, p < 0.001). Those in H&Y stages IV-V had more ADL disability than those in stage III (Mann–Whitney U test, p < 0.001), whereas there were no significant differences between the other stages. Conclusion PADLS revealed excellent data completeness, acceptable targeting, and external construct validity. It seems to be well suited as a rough estimate of ADL disability in people with PD.
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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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Lawrence BJ, Gasson N, Bucks RS, Troeung L, Loftus AM. Cognitive Training and Noninvasive Brain Stimulation for Cognition in Parkinson's Disease: A Meta-analysis. Neurorehabil Neural Repair 2017; 31:597-608. [PMID: 28583011 DOI: 10.1177/1545968317712468] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many people with Parkinson's disease (PD) experience cognitive decline. It is not known whether cognitive training or noninvasive brain stimulation are effective at alleviating cognitive deficits in PD. OBJECTIVE To examine cognitive training and non-invasive brain stimulation interventions for cognition in PD. METHODS An extensive search was conducted of published and unpublished studies in online databases. Studies were selected if they were controlled trials examining standard (not individualized) or tailored (individualized) cognitive training, repetitive transcranial magnetic stimulation (rTMS), or transcranial direct current stimulation (tDCS) in PD, with outcomes measured by standardized neuropsychological tests. RESULTS Fourteen controlled trials met inclusion criteria. For executive function, the pooled effect size (Hedges' g) for cognitive training (standard and tailored combined) was small ( g = 0.42) but statistically significant (95% CI 0.15-0.68). The pooled effect for standard cognitive training (alone) was medium ( g = 0.51) and significant (95% CI 0.16-0.85). For attention/working memory, small pooled effect sizes were found when combining standard and tailored cognitive training ( g = 0.23; 95% CI 0.02-0.44) and for standard cognitive training alone ( g = 0.29; 95% CI 0.04-0.53), both significant. For memory, small but significant pooled effect sizes were also found when combining standard and tailored cognitive training and for standard cognitive training alone. CONCLUSIONS The results suggest that standard and tailored cognitive training may improve executive function, attention/working memory, and memory in PD. Future studies must adopt randomized controlled trial designs to explore the therapeutic potential of these interventions.
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Affiliation(s)
| | - Natalie Gasson
- 1 Curtin University, Bentley, Western Australia, Australia
| | - Romola S Bucks
- 2 The University of Western Australia, Perth, Western Australia, Australia
| | - Lakkhina Troeung
- 2 The University of Western Australia, Perth, Western Australia, Australia.,3 The University of Notre Dame Australia, Fremantle, Western Australia, Australia
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Rosińczuk J, Kołtuniuk A. The influence of depression, level of functioning in everyday life, and illness acceptance on quality of life in patients with Parkinson's disease: a preliminary study. Neuropsychiatr Dis Treat 2017; 13:881-887. [PMID: 28356744 PMCID: PMC5367601 DOI: 10.2147/ndt.s132757] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease, and its incidence will increase as the global population ages. Due to the multitude of symptoms, this disease clearly has a significant impact on decreasing quality of life for those with PD. We aimed to evaluate the effect of selected variables on quality of life in people with idiopathic PD treated pharmacologically. MATERIALS AND METHODS This study was conducted among 50 patients with PD aged 47-85 years. The diagnostic survey method was applied to collect data with the use of the authors' questionnaire and standardized questionnaires, including, Parkinson's Disease Questionnaire (PDQ), Beck Depression Inventory, Instrumental Activities of Daily Living Scale, and Acceptance of Illness Scale. The results were statistically analyzed. RESULTS Analysis of the study material showed that people who were more self-reliant were characterized by lower intensity of depressive symptoms (ρ=-0.567, P=0), were more likely to accept their illness (ρ=0.611, P=0), and assessed quality of life better in each of the studied domains of the PDQ. Illness acceptance correlated with the occurrence of depressive symptoms (ρ=-0.567, P=0) and significantly affected quality of life. CONCLUSION Factors such as depression, disease acceptance, and functional capacity have a significant impact on the subjective assessment of quality of life in patients with PD. Evaluation of these factors should be taken into account in the therapeutic process, to minimize their negative impact on quality of life in patients with PD.
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Affiliation(s)
- Joanna Rosińczuk
- Department of Nervous System Diseases, Faculty of Health Science at Wrocław Medical University, Wrocław, Poland
| | - Aleksandra Kołtuniuk
- Department of Nervous System Diseases, Faculty of Health Science at Wrocław Medical University, Wrocław, Poland
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Almeida L, Ahmed B, Walz R, De Jesus S, Patterson A, Martinez-Ramirez D, Vaillancourt D, Bowers D, Ward H, Okun MS, McFarland NR. Depressive Symptoms are Frequent in Atypical Parkinsonian Disorders. Mov Disord Clin Pract 2016; 4:191-197. [PMID: 28944256 DOI: 10.1002/mdc3.12382] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To compare the incidence and prevalence of depressive symptoms in atypical parkinsonian (APD) syndromes versus Parkinson disease (PD). METHODS In a large retrospective patient cohort we analyzed the incidence and prevalence of depressive symptoms using the Beck Depression Inventory (BDI) and evaluated subjects longitudinally on subsequent visits. For individuals who followed in subsequent visits we calculated incidence rates in person-years as a measure of incidence. RESULTS We identified 361 patients with APD including Progressive Supranuclear Palsy (PSP), Corticobasal Degeneration (CBD), Multiple System Atrophy (MSA) and Dementia with Lewy Bodies (DLB), and 2352 PD controls. The mean BDI values were significantly higher in APD (F=14.19, p < 0.001). A significantly higher proportion of APD subjects screened positive for depressive symptoms both at initial and subsequent patient visits (p < 0.001), which appeared to be more severe in the APD subgroups. UPDRS part III and disease duration weakly correlated with depressive symptoms. CONCLUSIONS Our results suggest that the incidence and prevalence of depressive symptoms are higher in APD and appear also to be more severe than in PD. Depressive symptoms in APD are common and affect patients regardless of disease duration or motor severity.
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Affiliation(s)
- Leonardo Almeida
- Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States
| | - Bilal Ahmed
- Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States
| | - Roger Walz
- Department of Neurology, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Sol De Jesus
- Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States
| | - Addie Patterson
- Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States
| | - Daniel Martinez-Ramirez
- Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States
| | - David Vaillancourt
- Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States.,Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, United States
| | - Dawn Bowers
- Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States.,Department of Clinical & Health Psychology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States
| | - Herbert Ward
- Department of Psychiatry, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States
| | - Michael S Okun
- Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States
| | - Nikolaus R McFarland
- Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, Gainesville, Florida, United States
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Association Between Parkinson's Disease and Inflammatory Bowel Disease: a Nationwide Taiwanese Retrospective Cohort Study. Inflamm Bowel Dis 2016; 22:1049-55. [PMID: 26919462 DOI: 10.1097/mib.0000000000000735] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Inflammatory bowel disease (IBD) is a chronic inflammatory disorder. Previous studies have suggested that chronic systemic inflammation increases the risk of Parkinson's disease (PD). This study examined the effects of IBD on the development of PD. METHODS In a nationwide population-based cohort of 23.22 million insured residents of Taiwan aged ≥ 20 years, we compared people diagnosed with IBD during 2000 to 2011 (n = 8373) with IBD-free individuals. Patients with PD were identified in the National Health Insurance Research Database. Using univariable and multivariable Cox proportion hazard regression models, we estimated the adjusted hazard ratio (aHR) for PD with a 95% confidence interval (CI) with adjustment for age, sex, and comorbidities. RESULTS In the cohort, IBD was associated with an increased incidence of PD (crude hazard ratio = 1.43, 95% CI = 1.15-1.79). The risk was highest among individuals with Crohn's disease (aHR = 1.40, 95% CI = 1.11-1.77). In the multivariable model, the risk of PD was increased for men (aHR = 1.28, 95% CI = 1.05-1.56) and higher for patients with hypertension (aHR = 1.72, 95% CI = 1.33-2.24), coronary artery disease (aHR = 1.31, 95% CI = 1.04-1.66), or depression (aHR = 2.51, 95% CI = 1.82-3.46). CONCLUSIONS We suggest that IBD is associated with an increased risk of PD. Patients with IBD should be aware of the potential risk for PD development.
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Petri D, de Souza Silva M, Chao OH, Schnitzler A, Huston J. Serotonergic interaction between medial prefrontal cortex and mesotelencephalic DA system underlies cognitive and affective deficits in hemiparkinsonian rats. Neuroscience 2015; 307:51-63. [DOI: 10.1016/j.neuroscience.2015.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/07/2015] [Accepted: 08/12/2015] [Indexed: 01/25/2023]
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Chao YX, Chew LM, Deng X, Tan EK. Nonmotor symptoms in sporadic versus familial forms of Parkinson's disease. Neurodegener Dis Manag 2015; 5:147-53. [DOI: 10.2217/nmt.14.57] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
SUMMARY Besides the classical motor symptoms, Parkinson's disease (PD) patients experience a wide range of nonmotor symptoms (NMS) throughout the disease course. However, due to the lack of recognition and understanding of the pathogenesis, NMS symptoms may be overlooked. Familial PD is a well-defined group that can provide a good model to investigate the mechanisms for both motor and NMS in PD. Some studies suggest that the frequency of NMS is not different between genetic and sporadic form of PD while others suggest that specific domains (such as neuropsychiatric symptoms) are more common in the genetic form. Early recognition of NMS may facilitate early diagnosis and monitoring of both sporadic and genetic PD.
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Affiliation(s)
- Yin Xia Chao
- National Neuroscience Institute, Singapore 308433, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore
| | - Lai Mun Chew
- National Neuroscience Institute, Singapore 308433, Singapore
- Department of Neurology, Singapore General Hospital, Singapore 169608, Singapore
| | - Xiao Deng
- National Neuroscience Institute, Singapore 308433, Singapore
- Department of Neurology, Singapore General Hospital, Singapore 169608, Singapore
| | - Eng-King Tan
- National Neuroscience Institute, Singapore 308433, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore 169857, Singapore
- Department of Neurology, Singapore General Hospital, Singapore 169608, Singapore
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Anderson G, Maes M. The gut–brain axis: The role of melatonin in linking psychiatric, inflammatory and neurodegenerative conditions. ADVANCES IN INTEGRATIVE MEDICINE 2015. [DOI: 10.1016/j.aimed.2014.12.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Soundy A, Stubbs B, Roskell C. The experience of Parkinson's disease: a systematic review and meta-ethnography. ScientificWorldJournal 2014; 2014:613592. [PMID: 25525623 PMCID: PMC4265687 DOI: 10.1155/2014/613592] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 11/03/2014] [Accepted: 11/06/2014] [Indexed: 11/17/2022] Open
Abstract
There has been little attempt to summarise and synthesise qualitative studies concerning the experience and perception of living with Parkinson's disease. Bringing this information together would provide a background to understand the importance of an individual's social identity on their well-being and hope. Three primary aims were identified (a) understanding the importance of social identity and meaningful activities on individuals' well-being, (b) identifying factors and strategies that influence well-being and hope, and (c) establishing a model that relates to an individual's hope and well-being. Three stages were undertaken including a traditional electronic search, a critical appraisal of articles, and a synthesis of studies. Qualitative articles were included that considered the experience of living with Parkinson's disease. Thirty seven articles were located and included in the review. Five themes were identified and the themes were used to inform development of a new model of hope enablement. The current review furthered understanding of how physical symptoms and the experience of Parkinson's disease affect the individual's well-being and hope. Social identity was established as a key factor that influenced an individual's well-being. Being able to maintain, retain, or develop social identities was essential for the well-being and hope of individuals with Parkinson's disease. Understanding the factors which prevent or can facilitate this is essential.
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Affiliation(s)
- Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, London SE9 2UG, UK
| | - Carolyn Roskell
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
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