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Cardenas Soriano P, Rodriguez-Blazquez C, Forjaz MJ, Ayala A, Fernandez-Mayoralas G, Rojo-Perez F, Sanchez-Gonzalez D, Rodriguez-Rodriguez V. Associated factors for fear of COVID-19 scale in long-term care settings in Spain. Geriatr Nurs 2024; 56:167-172. [PMID: 38354659 DOI: 10.1016/j.gerinurse.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/11/2024] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE To examine the relationship between the Fear of COVID-19 Scale (FCV-19S) score and sociodemographic, health, emotional and behavioural factors, in a cross-sectional observational study in 447 older adults living in long-term care (LTC) settings in Madrid (Spain). METHODS The sample was stratified by nursing home ownership, geographical location, and size. Multiple linear regression analysis was used using backward elimination to identify factors that explained associations with fear, and logistic regression models were used to examine its role as a predictor of adherence to preventive measures. RESULTS The mean age of the participants was 83.8 years, most were female, had had COVID-19, and were worried about the pandemic. The average score of the FCV-19S was 18.36 (SD: 8.28; range: 7-35), and the variables associated in the multiple linear regression model (explained variance: 34.00%) were being female, lower level of education, satisfaction with life and the residential home, and higher worry about the pandemic. The logistic regression models showed that fear of COVID-19 was a predictor of adherence to preventive measures like wearing facemasks, washing hands, and avoiding physical contact. CONCLUSIONS fear of COVID-19 was significantly related with sex and subjective factors as life satisfaction and worry; and it influences older people's preventive behaviour. Interventions aimed at reducing fear and promoting adherence to preventive measures would improve their mental health and well-being.
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Affiliation(s)
- Pilar Cardenas Soriano
- Preventive Medicine Unit, Alcorcón Foundation University Hospital, Alcorcón, Spain; Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Madrid, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology and Network Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain.
| | - Maria João Forjaz
- National Centre of Epidemiology and Health Service Research Network on Chronic Diseases (REDISSEC) and Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Institute of Health, Madrid, Spain
| | - Alba Ayala
- Department of Statistics, University Carlos III of Madrid, and Health Service Research Network on Chronic Diseases (REDISSEC), Carlos III Institute of Health, Madrid, Spain
| | | | - Fermina Rojo-Perez
- Grupo de Investigacion sobre Envejecimiento (GIE-CSIC), IEGD, CSIC, Madrid, Spain
| | - Diego Sanchez-Gonzalez
- Department of Geography, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Magalhães AD, Amstutz D, Petermann K, Debove I, Sousa M, Maradan-Gachet ME, Lachenmayer ML, Waskönig J, Murcia-Carretero S, Diamantaras AA, Tinkhauser G, Nowacki A, Pollo C, Rodriguez-Blazquez C, Martinez-Martin P, Krack P. Subthalamic stimulation has acute psychotropic effects and improves neuropsychiatric fluctuations in Parkinson's disease. BMJ Neurol Open 2024; 6:e000524. [PMID: 38196982 PMCID: PMC10773312 DOI: 10.1136/bmjno-2023-000524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 01/11/2024] Open
Abstract
Background Subthalamic nucleus deep brain stimulation (STN-DBS) is a well-established treatment for motor complications in Parkinson's disease (PD). However, its effects on neuropsychiatric symptoms remain disputed. The aim of this study was to evaluate the effects of STN-DBS on neuropsychiatric symptoms in PD. Methods We retrospectively assessed 26 patients with PD who underwent a preoperative levodopa challenge and postoperative levodopa and stimulation challenges 1 year after STN-DBS. Based on the Neuropsychiatric Fluctuations Scale, Neuropsychiatric State Scores and Neuropsychiatric Fluctuation Indices (NFIs) were calculated. Mixed-effects models with random effects for intercept were used to examine the association of Neuropsychiatric State Score and NFI with the different assessment conditions. Results In acute challenge conditions, there was an estimated increase of 15.9 points in the Neuropsychiatric State Score in stimulation ON conditions (95% CI 11.4 to 20.6, p<0.001) and 7.6 points in medication ON conditions (95% CI 3.3 to 11.9, p<0.001). Neuropsychiatric fluctuations induced by levodopa, quantified with NFI, decreased by 35.54% (95% CI 49.3 to 21.8, p<0.001) 1 year after STN-DBS. Conclusions Bilateral STN-DBS at therapeutic parameters has acute psychotropic effects similar to levodopa and can modulate and decrease levodopa-induced neuropsychiatric fluctuations.
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Affiliation(s)
- Andreia D Magalhães
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Deborah Amstutz
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Katrin Petermann
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Mário Sousa
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Marie E Maradan-Gachet
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | | | - Julia Waskönig
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | | | | | - Gerd Tinkhauser
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Inselspital University Hospital Bern, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, Inselspital University Hospital Bern, Bern, Switzerland
| | - Carmen Rodriguez-Blazquez
- National Epidemiology Center, Carlos III Health Institute, Madrid, Spain
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, Madrid, Spain
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, Madrid, Spain
| | - Paul Krack
- Department of Neurology, Inselspital University Hospital Bern, Bern, Switzerland
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Metta V, Ibrahim H, Muralidharan N, Rodriguez K, Masagnay T, Mohan J, Lacsina A, Ahmed A, Benamer HTS, Chung-Faye G, Mrudula R, Falup-Pecurariu C, Rodriguez-Blazquez C, Borgohain R, Goyal V, Bhattacharya K, Chaudhuri KR. A 12-month prospective real-life study of opicapone efficacy and tolerability in Emirati and non-White subjects with Parkinson's disease based in United Arab Emirates. J Neural Transm (Vienna) 2024; 131:25-30. [PMID: 37798410 PMCID: PMC10769978 DOI: 10.1007/s00702-023-02700-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/17/2023] [Indexed: 10/07/2023]
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder, and the condition is complicated by the emergence of wearing off/motor fluctuations with levodopa treatment after a variable period. COMT inhibitors when used as adjunct therapy to levodopa tend to smoothen out these wearing off fluctuations by enhancing delivery of levodopa and increasing its bioavailability to the brain. The study was conducted to investigate the motor and nonmotor effect, safety and tolerability of the third generation once-daily COMT inhibitor (opicapone), as add-on, adjuvant therapy to levodopa and at 6 and 12 months follow-up in a real-life cohort of consecutive Emirati and non-White PD patients. A real-life observational analysis using tolerability parameters as used previously by Rizos et al. and Shulman et al. based on clinical database of cases rat Kings College Hospital Dubai Parkinson care database. This was a prospective, single-arm follow-up clinical evaluation study that evaluated the effectiveness of opicapone 50 mg once-daily regime in 50 patients diagnosed with idiopathic neurodegenerative disorder. All patients were assessed with scales used in clinical pathway and include motor Unified Parkinson's Disease Rating Scale (UPDRS), nonmotor symptom scale (NMSS), quality of life (PDQ8) Parkinson's fatigue scale (PFS16) and King's Parkinson's Pain Scale (KIPS). Out of 50 patients treated with opicapone (72% male, mean age 66.9 years (SD 9.9, range 41-82 years) and mean duration of disease 5.7 years (SD 2.5 range (2-11), there was significant statistical improvements shown in motor function-UPDRS part 3: baseline 40.64 ± 2.7, at 6 months 32.12 ± 3.14 and after 12 months 33.72 ± 3.76. Nonmotor burden NMSS: 107.00 ± 21.86, at 6 months 100.78 ± 17.28 and 12 months 96.88 ± 16.11. Reduction in dyskinesias (UPDRS part 4): baseline 8.78 ± 1.07, at 6 months 7.4 ± 0.81 and 12 months 6.82 ± 0.75. Opicapone provides beneficial motor and nonmotor effects in Emirati and other non-White Parkinson's patients, resident in UAE, proving its efficacy across different racial groups as COMT activity may vary between races.
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Affiliation(s)
- Vinod Metta
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK.
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Dubai, United Arab Emirates.
| | - Huzaifa Ibrahim
- Parkinson's Association United Arab Emirates, Dubai, United Arab Emirates
| | - Neha Muralidharan
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Dubai, United Arab Emirates
| | - Kislyn Rodriguez
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Dubai, United Arab Emirates
| | - Therese Masagnay
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Dubai, United Arab Emirates
| | - Judith Mohan
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Dubai, United Arab Emirates
| | - Arlet Lacsina
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Dubai, United Arab Emirates
| | - Abdullah Ahmed
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Dubai, United Arab Emirates
| | - Hani T S Benamer
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Guy Chung-Faye
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Dubai, United Arab Emirates
| | - Rukmini Mrudula
- Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | | | | | - Rupam Borgohain
- Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Vinay Goyal
- Institute of Movement Disorders and Parkinson's Centre, Medanta Hospitals, Delhi, India
| | | | - K Ray Chaudhuri
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Dubai, United Arab Emirates
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Metta V, Dhamija RK, Batzu L, Mrudula R, Kumar NSS, S A, Falup-Pecurariu C, Rodriguez-Blazquez C, Goyal V, L K P, Bhattacharya K, Kumar S, Chaudhuri KR, Borgohain R. Safety and tolerability of long-term apomorphine infusion in advanced Parkinson's disease: an Indian multi-center (APO-IND) experience. Sci Rep 2023; 13:18681. [PMID: 37907679 PMCID: PMC10618227 DOI: 10.1038/s41598-023-46003-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/26/2023] [Indexed: 11/02/2023] Open
Abstract
Advanced Parkinson's Disease (APD) is complicated by the emergence of motor and non-motor fluctuations, which are initially predictable and eventually become unpredictable, in part due to erratic gastric absorption and short half of oral levodopa. Attempts to manage such fluctuations with oral dopaminergic drugs often lead to disabling dyskinesias. Continuous Subcutaneous Apomorphine Infusion (CSAI), despite being approved for the treatment of APD since 1993, was approved in India only in 2019. We studied the safety, tolerability and efficacy of CSAI in Indian patients with APD in a registry design to raise local awareness of this important treatment. We conducted a prospective registry-based observational audit at 10 centers across different states of India. Patients with APD, not responding to or with significant side effects from oral dopaminergic therapy, were assessed at baseline and at month 6 and 12 following CSAI infusion. Fifty-one patients completed the study, CSAI significantly reduced the functional impact of dyskinesia (p < 0.01 at 6 months and p < 0.001 at 12 months). There was a significant improvement in the OFF-state from baseline (p < 0.01 at 6 months and p < 0.001 at 12 months) No discernible side effects were observed apart from mild site reaction (n = 7), nausea (n = 7) skin nodules (n = 2). CSAI demonstrated safety, efficacy, tolerability and improved quality of life in patients with APD, as shown in previous studies. Our study highlighted current existing inequalities in treatment availability, lack of awareness, knowledge gap, affordability and cost remains a concern regarding apomorphine use in Indian PD population.
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Affiliation(s)
- Vinod Metta
- Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience and Parkinson's Foundation Centre of Excellence, King's College London, King's College Hospital, London, UK.
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, Dubai, United Arab Emirates.
- Parkinson's Foundation Centre of Excellence, King's College Hospital London, London, SE5 9RS, UK.
| | - Rajinder K Dhamija
- Institute of Human Behavior and Allied Sciences, Lady Hardinge Medical College and SSK Hospital, New Delhi, India
| | - Lucia Batzu
- Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience and Parkinson's Foundation Centre of Excellence, King's College London, King's College Hospital, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, Dubai, United Arab Emirates
| | - Rukmini Mrudula
- Institute of Movement Disorders, Narayana Medical College and Postgraduate Research Centre, Nellore, India
- Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Natuva Sai Sampath Kumar
- Institute of Movement Disorders, Narayana Medical College and Postgraduate Research Centre, Nellore, India
| | - Arunan S
- SRM Institute of Medical Sciences and Technology, Chennai, India
| | | | | | - Vinay Goyal
- Institute of Movement Disorders and Parkinson's Centre, Medanta Hospital, New Delhi, India
| | - Prashanth L K
- Center for Parkinson's Disease and Movement Disorders, Manipal Hospital, Bangalore, India
| | | | - Suresh Kumar
- Amrita Institute of Medical Sciences, Kochi, India
| | - Kallol Ray Chaudhuri
- Department of Neurosciences, Institute of Psychiatry, Psychology and Neuroscience and Parkinson's Foundation Centre of Excellence, King's College London, King's College Hospital, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, Dubai, United Arab Emirates
| | - Rupam Borgohain
- Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
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Alfaro-Díaz C, Esandi N, Pueyo-Garrigues M, Canga-Armayor N, Forjaz MJ, Rodriguez-Blazquez C, Canga-Armayor A. Psychometric Evaluation of the Spanish Families Importance in Nursing Care: Nurses' Attitudes Scale Through Classical Test Theory and Rasch Analysis. J Fam Nurs 2023; 29:179-191. [PMID: 36647194 DOI: 10.1177/10748407221148083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Nurses' attitudes toward families play an important role in improving relationships with patients' families. It is essential to have valid and reliable instruments to assess nurses' attitudes toward involving families. The aim of this study was to analyze the psychometric properties of the refined Spanish version of the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) according to classical test theory and the Rasch model (N = 263). Cronbach's alpha values were .73 to .87 and intraclass correlation coefficients ranged from .72 to .86. Rasch analysis results suggested that it was a multidimensional scale with four dimensions and a simpler response scheme than the original scale. Except for one item, the scale was free from bias regarding age and experience time. The FINC-NA is a reliable and valid measure showing a good fit to the Rasch model and is ready to map nurses' attitudes and measure the effectiveness of family nursing educational interventions.
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Affiliation(s)
- Cristina Alfaro-Díaz
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - Nuria Esandi
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - María Pueyo-Garrigues
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - Navidad Canga-Armayor
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | | | | | - Ana Canga-Armayor
- IUniversity of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
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Leta V, van Wamelen DJ, Aureli F, Metta V, Trivedi D, Cortelli P, Rodriguez-Blazquez C, Rizos A, Ray Chaudhuri K. The real-life effect of catechol-O-methyltransferase inhibition on non-motor symptoms in levodopa-treated Parkinson's disease: opicapone versus entacapone. J Neural Transm (Vienna) 2023:10.1007/s00702-023-02603-y. [PMID: 37036498 DOI: 10.1007/s00702-023-02603-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/13/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVE To evaluate the long-term, real-life effects on non-motor symptoms (NMS) of opicapone compared to entacapone in levodopa-treated people with Parkinson's disease (PwP). METHODS A retrospective data analysis, with pre- and post-opicapone initiation data of 17 PwP with motor fluctuations compared to a comparable group of 18 PwP introduced on entacapone. The primary outcome was changes in the NMS Scale (NMSS) total score after 1-year follow-up. Secondary outcomes included changes in the NMSS domains, and Parkinson's Disease Sleep Scale (PDSS) total and item scores after the same time span. RESULTS Groups were comparable for baseline demographics and Parkinson's-related features (p ≥ 0.314) as well as duration of follow-up (1.33 ± 0.66 years for PwP on opicapone and 1.23 ± 0.49 years for those on entacapone; p = 0.858). PwP who were introduced on opicapone showed no changes in NMSS and PDSS total scores after 1 year (p = 0.605 and p = 0.507, respectively), whereas PwP who were introduced on entacapone showed significant worsening of NMSS and PDSS total scores at follow-up (p = 0.005 and p = 0.001, respectively). In neither group changes in individual NMSS domains from baseline to follow-up were observed (p ≥ 0.288 for entacapone and p ≥ 0.816 for opicapone, respectively). In PwP on entacapone significant worsening was seen in the distressing dreams, hallucinations, and limb numbness items of the PDSS (p ≤ 0.05). CONCLUSIONS Introduction of opicapone in real-life PwP with motor fluctuations seems to stabilise NMS burden and aspects of sleep dysfunction, in contrast to entacapone where there was a worsening of NMS burden and PDSS scores over 1 year follow-up.
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Affiliation(s)
- Valentina Leta
- Department of Basic and Clinical Neuroscience, King's College London, Institute of Psychiatry, Psychology and Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Cutcombe Road, London, SE5 9RT, UK
- Parkinson's Foundation Center of Excellence, King's College Hospital, London, UK
| | - Daniel J van Wamelen
- Parkinson's Foundation Center of Excellence, King's College Hospital, London, UK
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Federico Aureli
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Vinod Metta
- Parkinson's Foundation Center of Excellence, King's College Hospital, London, UK
- King's College Hospital London, Dubai, United Arab Emirates
| | - Dhaval Trivedi
- Department of Basic and Clinical Neuroscience, King's College London, Institute of Psychiatry, Psychology and Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Cutcombe Road, London, SE5 9RT, UK
- Parkinson's Foundation Center of Excellence, King's College Hospital, London, UK
| | - Pietro Cortelli
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | | | - Alexandra Rizos
- Parkinson's Foundation Center of Excellence, King's College Hospital, London, UK
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, King's College London, Institute of Psychiatry, Psychology and Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Cutcombe Road, London, SE5 9RT, UK.
- Parkinson's Foundation Center of Excellence, King's College Hospital, London, UK.
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Rojo-Perez F, Rodriguez-Rodriguez V, Fernandez-Mayoralas G, Sánchez-González D, Perez de Arenaza Escribano C, Rojo-Abuin JM, Forjaz MJ, Molina-Martínez MÁ, Rodriguez-Blazquez C. Residential Environment Assessment by Older Adults in Nursing Homes during COVID-19 Outbreak. Int J Environ Res Public Health 2022; 19:16354. [PMID: 36498426 PMCID: PMC9739633 DOI: 10.3390/ijerph192316354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
The most vulnerable residential settings during the COVID-19 pandemic were older adult's nursing homes, which experienced high rates of incidence and death from this cause. This paper aims to ascertain how institutionalized older people assessed their residential environment during the pandemic and to examine the differences according to personal and contextual characteristics. The COVID-19 Nursing Homes Survey (Madrid region, Spain) was used. The residential environment assessment scale (EVAER) and personal and contextual characteristics were selected. Descriptive and multivariate statistical analysis were applied. The sample consisted of 447 people (mean age = 83.8, 63.1% = women, 50.8% = widowed, 40% = less than primary studies). Four residential assessment subscales (relationships, mobility, residential aspects, privacy space) and three clusters according to residential rating (medium-high with everything = 71.5% of cases, low with mobility = 15.4%, low with everything = 13.1%) were obtained. The logistic regression models for each cluster category showed to be statistically significant. Showing a positive affect (OR = 1.08), fear of COVID-19 (OR = 1.06), high quality of life (OR = 1.05), not having suspicion of depression (OR = 0.75) and performing volunteer activities (OR = 3.67) were associated with the largest cluster. It is concluded that a better residential evaluation was related to more favourable personal and contextual conditions. These results can help in the design of nursing homes for older adults in need of accommodation and care to facilitate an age-friendly environment.
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Affiliation(s)
- Fermina Rojo-Perez
- Grupo de Investigacion sobre Envejecimiento (GIE), IEGD, CSIC, 28037 Madrid, Spain
| | | | | | - Diego Sánchez-González
- Department of Geography, National Distance Education University (UNED), 28040 Madrid, Spain
| | | | | | - Maria João Forjaz
- National Centre of Epidemiology and Health Service Research Network on Chronic Diseases (REDISSEC) and Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Institute of Health, 28029 Madrid, Spain
| | - María-Ángeles Molina-Martínez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, National Distance Education University (UNED), 28040 Madrid, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology and Network Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, 28029 Madrid, Spain
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Cárdenas Soriano P, Rodriguez-Blazquez C, Forjaz MJ, Ayala A, Rojo-Perez F, Fernandez-Mayoralas G, Molina-Martinez MA, de Arenaza Escribano CP, Rodriguez-Rodriguez V. Validation of the Spanish Version of the Fear of COVID-19 Scale (FCV-19S) in Long-Term Care Settings. Int J Environ Res Public Health 2022; 19:16183. [PMID: 36498256 PMCID: PMC9741095 DOI: 10.3390/ijerph192316183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Fear of coronavirus disease 2019 (COVID-19) is one of the main psychological impacts of the actual pandemic, especially among the population groups with higher mortality rates. The Fear of COVID-19 Scale (FCV-19S) has been used in different scenarios to assess fear associated with COVID-19, but this has not been done frequently in people living in long-term care (LTC) settings. The present study is aimed at measuring the psychometric properties of the Spanish version of the FCV-19S in residents in LTC settings, following both the classical test theory (CTT) and Rasch model frameworks. The participants (n = 447), aged 60 years or older, were asked to complete the FCV-19S and to report, among other issues, their levels of depression, resilience, emotional wellbeing and health-related quality of life with validated scales. The mean FCV-19S score was 18.36 (SD 8.28, range 7−35), with higher scores for women, participants with lower education (primary or less) and higher adherence to preventive measures (all, p < 0.05). The Cronbach’s alpha for the FCV-19S was 0.94. After eliminating two items due to a lack of fit, the FCV-19S showed a good fit to the Rasch model (χ2 (20) = 30.24, p = 0.019, PSI = 0.87), with unidimensionality (binomial 95% CI 0.001 to 0.045) and item local independency. Question 5 showed differential item functioning by sex. The present study shows that the FCV-19S has satisfactory reliability and validity, which supports its use to effectively measure fear in older people living in LTC settings. This tool could help identify risk groups that may need specific health education and effective communication strategies to lower fear levels. This might have a beneficial impact on adherence to preventive measures.
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Affiliation(s)
- Pilar Cárdenas Soriano
- Department of Preventive Medicine, University Hospital of Albacete, ES-02006 Albacete, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology and Network Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, ES-28029 Madrid, Spain
| | - Maria João Forjaz
- National Centre of Epidemiology and Health Service Research Network on Chronic Diseases (REDISSEC) and Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Institute of Health, ES-28029 Madrid, Spain
| | - Alba Ayala
- Department of Statistics, University Carlos III of Madrid, and Health Service Research Network on Chronic Diseases (REDISSEC), Carlos III Institute of Health, ES-28029 Madrid, Spain
| | - Fermina Rojo-Perez
- Grupo de Investigacion Sobre Envejecimiento (GIE), IEGD, CSIC, ES-28037 Madrid, Spain
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Garriga C, Valero T, Diaz A, Rodriguez-Blazquez C, Forjaz MJ. Review of direct impact health indicators of COVID-19 in the scientific literature published between January 2020 and June 2021. Eur J Public Health 2022. [PMCID: PMC9593807 DOI: 10.1093/eurpub/ckac129.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The Joint Action Population Health Information Research Infrastructure (PHIRI) seeks to create infrastructures to generate quality data on the COVID-19 pandemic between European countries. The aim of this study is to present a synthesis of health indicators used to evaluate the direct impact of COVID-19 Methods Scoping review using a common search strategy in Pubmed, Embase and WHO Covid-19 databases. Health indicators of direct impact of COVID-19 were obtained from observational studies in the general population, hospitals and long-term care facilities from papers published worldwide in English between 01/01/2020 and 06/31/2021. Titles and abstracts were screened first by 15 reviewers using the Rayyan tool. Any discrepancies were solved by agreement between reviewers. Then, articles containing indicators of direct impact were selected in a full-text reading phase. Of them, a random sample of 35 was drawn and their indicators were described. Results After eliminating 262 duplicates 3891 records were reviewed. Screening discarded 3171 abstracts. Of 720 articles sought for retrieval, 445 met inclusion criteria for indicators extraction. In a sample of 35 papers (8.1%), 116 direct impact indicators of COVID-19 were identified. 28 morbidity indicators were found, classified as indicators of prevalence (n = 15), incidence (6), transmissibility (4) and underreported infection (4); 32 of mortality (mortality rate, 9; case fatality rate, 17; time to death, 2); and 54 for severity (complications, 27; mechanical ventilation, 12; hospitalization, 8; requiring ICU admission, 1; time from hospitalization to ICU admission, 1). Two composite indicators of severity and mortality were also identified. Conclusions According to the scientific literature, a wide variety of health indicators has been used to measure the direct impact of COVID-19. The systematization of indicators used in the current COVID-19 pandemic could help for future health crises management.
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Affiliation(s)
- C Garriga
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
- Contact:
| | - T Valero
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - A Diaz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | | | - MJ Forjaz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
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Rodriguez-Blazquez C, Romay-Barja M, Falcon M, Ayala A, Forjaz MJ. Psychometric Properties of the COVID-19 Pandemic Fatigue Scale: Cross-sectional Online Survey Study. JMIR Public Health Surveill 2022; 8:e34675. [PMID: 35785547 PMCID: PMC9501671 DOI: 10.2196/34675] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/18/2022] [Accepted: 06/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Pandemic fatigue is defined as feelings of demotivation to follow preventive measures against COVID-19, together with decreased trust in government and frequency of information-seeking behaviors. Objective This study aims to analyze the psychometric properties of the COVID-19–specific pandemic fatigue scale according to classical test theory (CTT) and Rasch model approaches in the general Spanish population. Methods This was a cross-sectional study in a representative sample of 1018 adults who completed an online survey in November 2020 in the framework of the COVID-19 Snapshot Monitoring (COSMO)-Spain project. The assessments included the 6-item COVID-19 Pandemic Fatigue Scale (CPFS) and other COVID-19–related variables: COVID-19 infection, adherence to preventive behaviors, information-seeking behavior, self-efficacy, worry, and cognitive and affective risk perception. Data quality, acceptability, reliability, and validity were analyzed according to CTT, and the fit to the Rasch model, unidimensionality, appropriateness of the response scale, item local independency, reliability (person-separation index [PSI]), and item-person distribution were also calculated. Results The mean CPFS score was 17.06 (SD 5.04, range 6-30), with higher scores for women, younger participants, participants who never seek information on COVID-19, those who think they would contract a mild disease in case of infection, those with higher level of worry about coronavirus/COVID-19, and those who felt depressed or felt the coronavirus/COVID-19 is spreading slowly (all P<.01). The Cronbach alpha for the CPFS was 0.74. In the confirmatory factor analysis, one factor was identified (root mean square error of approximation [RMSEA]=.02; comparative fit index [CFI]=.99; χ25=8.06, P=.15). The CPFS showed good fit to the Rasch model (χ 224=42.025, P=.01, PSI=.642), unidimensionality (binomial 95% CI –.005 to .045), and item local independency. Conclusions Our results suggest that the CPFS has moderate reliability and internal consistency and it is composed of a single dimension. It is a useful tool to ascertain the level of pandemic fatigue in the general population, which may help to guide the communication and information strategies to face the COVID-19 pandemic.
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Affiliation(s)
| | - Maria Romay-Barja
- Nacional Center of Tropical Diseases, Carlos III Health Institute, Madrid, Spain
| | - Maria Falcon
- School of Medicine, University of Murcia, Murcia, Spain
| | - Alba Ayala
- Department of Statistics, Carlos III University, Getafe, Spain
| | - Maria João Forjaz
- National Epidemiology Center, Carlos III Health Institute, Madrid, Spain
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11
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de Bruin M, Suk JE, Baggio M, Blomquist SE, Falcon M, Forjaz MJ, Godoy-Ramirez K, Leurs M, Rodriguez-Blazquez C, Romay-Barja M, Uiters E, Kinsman J. Behavioural insights and the evolving COVID-19 pandemic. Euro Surveill 2022; 27:2100615. [PMID: 35514309 PMCID: PMC9074394 DOI: 10.2807/1560-7917.es.2022.27.18.2100615] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
Behavioural sciences have complemented medical and epidemiological sciences in the response to the SARS-CoV-2 pandemic. As vaccination uptake continues to increase across the EU/EEA - including booster vaccinations - behavioural science research remains important for both pandemic policy, planning of services and communication. From a behavioural perspective, the following three areas are key as the pandemic progresses: (i) attaining and maintaining high levels of vaccination including booster doses across all groups in society, including socially vulnerable populations, (ii) informing sustainable pandemic policies and ensuring adherence to basic prevention measures to protect the most vulnerable population, and (iii) facilitating population preparedness and willingness to support and adhere to the reimposition of restrictions locally or regionally whenever outbreaks may occur. Based on mixed-methods research, expert consultations, and engagement with communities, behavioural data and interventions can thus be important to prevent and effectively respond to local or regional outbreaks, and to minimise socioeconomic and health disparities. In this Perspective, we briefly outline these topics from a European viewpoint, while recognising the importance of considering the specific context in individual countries.
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Affiliation(s)
- Marijn de Bruin
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Radboud University Medical Center, Institute of Health Sciences, Nijmegen, the Netherlands
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Marianna Baggio
- Joint Research Centre, European Commission, Brussels, Belgium
| | | | - María Falcon
- Department of Legal and Forensic Medicine, Faculty of Medicine, Biomedical Research Institute (IMIB), University of Murcia, Murcia, Spain
| | - Maria João Forjaz
- National Epidemiology Centre, Carlos III Health Institute, Madrid, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
| | | | - Mariken Leurs
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - María Romay-Barja
- Infectious Disease Network Research Center (CIBERINFEC), Madrid, Spain
- National Centre of Tropical Medicine, Carlos III Health Institute, Madrid, Spain
| | - Ellen Uiters
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - John Kinsman
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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12
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Mortier P, Vilagut G, Alayo I, Ferrer M, Amigo F, Aragonès E, Aragón-Peña A, Asúnsolo del Barco A, Campos M, Espuga M, González-Pinto A, Haro J, López Fresneña N, Martínez de Salázar A, Molina J, Ortí-Lucas R, Parellada M, Pelayo-Terán J, Pérez-Gómez B, Pérez-Zapata A, Pijoan J, Plana N, Polentinos-Castro E, Portillo-Van Diest A, Puig M, Rius C, Sanz F, Serra C, Urreta-Barallobre I, Kessler R, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J, Alayo I, Alonso M, Álvarez M, Amann B, Amigo FF, Anmella G, Aragón A, Aragonés N, Aragonès E, Arizón AI, Asunsolo A, Ayora A, Ballester L, Barbas P, Basora J, Bereciartua E, Ignasi Bolibar IB, Bonfill X, Cotillas A, Cuartero A, de Paz C, Cura ID, Jesus del Yerro M, Diaz D, Domingo JL, Emparanza JI, Espallargues M, Espuga M, Estevan P, Fernandez MI, Fernandez T, Ferrer M, Ferreres Y, Fico G, Forjaz MJ, Barranco RG, Garcia TorrecillasC. Garcia-Ribera JM, Garrido A, Gil E, Gomez M, Gomez J, Pinto AG, Haro JM, Hernando M, Insigna MG, Iriberri M, Jimenez N, Jimenez X, Larrauri A, Leon F, Lopez-Fresneña N, Lopez C, Lopez-Atanes Juan Antonio Lopez-Rodriguez M, Lopez-Cortacans G, Marcos A, Martin J, Martin V, Martinez-Cortés M, Martinez-Martinez R, Martinez de Salazar AD, Martinez I, Marzola M, Mata N, Molina JM, de Dios Molina J, Molinero E, Mortier P, Muñoz C, Murru A, Olmedo J, Ortí RM, Padrós R, Pallejà M, Parra R, Pascual J, Pelayo JM, Pla R, Plana N, Aznar CP, Gomez BP, Zapata AP, Pijoan JI, Polentinos E, Puertolas B, Puig MT, Quílez A, Quintana MJ, Quiroga A, Rentero D, Rey C, Rius C, Rodriguez-Blazquez C, Rojas MJ, Romero Y, Rubio G, Rumayor M, Ruiz P, Saenz M, Sanchez J, Sanchez-Arcilla I, Sanz F, Serra C, Serra-Sutton V, Serrano M, Sola S, Solera S, Soto M, Tarrago A, Tolosa N, Vazquez M, Viciola M, Vieta E, Vilagut G, Yago S, Yañez J, Zapico Y, Zorita LM, Zorrilla I, Zurbano SL, Perez-Solá V. Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic. J Psychiatr Res 2022; 149:10-17. [PMID: 35217315 PMCID: PMC8852847 DOI: 10.1016/j.jpsychires.2022.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 12/22/2022]
Abstract
Healthcare workers (HCW) are at high risk for suicide, yet little is known about the onset of suicidal thoughts and behaviors (STB) in this important segment of the population in conjunction with the COVID-19 pandemic. We conducted a multicenter, prospective cohort study of Spanish HCW active during the COVID-9 pandemic. A total of n = 4809 HCW participated at baseline (May-September 2020; i.e., just after the first wave of the pandemic) and at a four-month follow-up assessment (October-December 2020) using web-based surveys. Logistic regression assessed the individual- and population-level associations of separate proximal (pandemic) risk factors with four-month STB incidence (i.e., 30-day STB among HCW negative for 30-day STB at baseline), each time adjusting for distal (pre-pandemic) factors. STB incidence was estimated at 4.2% (SE = 0.5; n = 1 suicide attempt). Adjusted for distal factors, proximal risk factors most strongly associated with STB incidence were various sources of interpersonal stress (scaled 0-4; odds ratio [OR] range = 1.23-1.57) followed by personal health-related stress and stress related to the health of loved ones (scaled 0-4; OR range 1.30-1.32), and the perceived lack of healthcare center preparedness (scaled 0-4; OR = 1.34). Population-attributable risk proportions for these proximal risk factors were in the range 45.3-57.6%. Other significant risk factors were financial stressors (OR range 1.26-1.81), isolation/quarantine due to COVID-19 (OR = 1.53) and having changed to a specific COVID-19 related work location (OR = 1.72). Among other interventions, our findings call for healthcare systems to implement adequate conflict communication and resolution strategies and to improve family-work balance embedded in organizational justice strategies.
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Affiliation(s)
- P. Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Corresponding author. IMIM, PRBB Building. Carrer del Doctor Aiguader 88, 08003, Barcelona, Spain
| | - G. Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - I. Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - M. Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - F. Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - E. Aragonès
- Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain,Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - A. Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain,Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - A. Asúnsolo del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain,Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain,Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - M. Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - M. Espuga
- Occupational Health Service. Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - A. González-Pinto
- Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain,CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - J.M. Haro
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Parc Sanitari Sant Joan de Déu, Barcelona, Spain,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | | | - J.D. Molina
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Villaverde Mental Health Center. Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain,Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain,Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - M. Parellada
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J.M. Pelayo-Terán
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Servicio de Psiquiatría y Salud Mental. Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain,Area de Medicina Preventiva y Salud Pública. Universidad de León, León, Spain
| | - B. Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - A. Pérez-Zapata
- Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - J.I. Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Hospital Universitario Cruces/ OSI EEC, Bilbao, Spain, Biocruces-Bizkaia Health Research Institute
| | - N. Plana
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - E. Polentinos-Castro
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain,Research Unit. Primary Care Management. Madrid Health Service, Madrid, Spain,Department of Medical Specialities and Public Health. King Juan Carlos University, Madrid, Spain,Health Services Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
| | - A. Portillo-Van Diest
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - M.T. Puig
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain,Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain,CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - C. Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - F. Sanz
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain,Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain,Instituto Nacional de Bioinformatica - ELIXIR-ES, Barcelona, Spain
| | - C. Serra
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Parc de Salut Mar PSMAR, Barcelona, Spain,CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - I. Urreta-Barallobre
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain,Biodonostia Health Research Institute, Clinical Epidemiology, San Sebastián, Spain
| | - R.C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R. Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - E. Vieta
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - V. Pérez-Solá
- CIBER Salud Mental (CIBERSAM), Madrid, Spain,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain,Parc de Salut Mar PSMAR, Barcelona, Spain
| | - J. Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,CIBER Epidemiología y Salud Pública (CIBERESP), Spain,Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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Rodriguez-Blazquez C, Forjaz MJ. Scales and assessments of sexual dysfunction. Int Rev Neurobiol 2022; 162:35-52. [PMID: 35397788 DOI: 10.1016/bs.irn.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sexual dysfunction is a very frequent non-motor symptom in Parkinson's disease (PD). However, patients are often reluctant to declare their sexual problems and many clinicians do not inquire about them during routine visits. The use of validated rating scales and questionnaires allows overcoming these difficulties, characterizing the nature and causes of the patient's sexual dysfunction, and helping to implement and monitor the most adequate interventions. There is a wide range of instruments available for assessing sexual dysfunction in PD, including generic and specific ones. In this chapter, we review the most used rating scales and questionnaires, with a description of its components, characteristics and psychometric attributes.
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Affiliation(s)
- Carmen Rodriguez-Blazquez
- National Epidemiology Centre, Carlos III Institute of Health, Madrid, Spain; Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.
| | - Maria João Forjaz
- National Epidemiology Centre, Carlos III Institute of Health, Madrid, Spain; Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
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Rodriguez-Blazquez C, Violante MR, Arakaki T, Garretto NS, Serrano-Dueñas M, Ibáñez IP, Ambrosio L. Living with chronic illness scale in Parkinson's disease: Longitudinal metric properties and meaningful change. Parkinsonism Relat Disord 2022; 96:1-5. [DOI: 10.1016/j.parkreldis.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/17/2021] [Accepted: 01/07/2022] [Indexed: 11/25/2022]
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Rodriguez-Sanchez F, Rodriguez-Blazquez C, Bielza C, Larrañaga P, Weintraub D, Martinez-Martin P, Rizos A, Schrag A, Chaudhuri KR. Identifying Parkinson's disease subtypes with motor and non-motor symptoms via model-based multi-partition clustering. Sci Rep 2021; 11:23645. [PMID: 34880345 PMCID: PMC8654994 DOI: 10.1038/s41598-021-03118-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/29/2021] [Indexed: 12/27/2022] Open
Abstract
Identification of Parkinson's disease subtypes may help understand underlying disease mechanisms and provide personalized management. Although clustering methods have been previously used for subtyping, they have reported generic subtypes of limited relevance in real life practice because patients do not always fit into a single category. The aim of this study was to identify new subtypes assuming that patients could be grouped differently according to certain sets of related symptoms. To this purpose, a novel model-based multi-partition clustering method was applied on data from an international, multi-center, cross-sectional study of 402 Parkinson's disease patients. Both motor and non-motor symptoms were considered. As a result, eight sets of related symptoms were identified. Each of them provided a different way to group patients: impulse control issues, overall non-motor symptoms, presence of dyskinesias and pyschosis, fatigue, axial symptoms and motor fluctuations, autonomic dysfunction, depression, and excessive sweating. Each of these groups could be seen as a subtype of the disease. Significant differences between subtypes (P< 0.01) were found in sex, age, age of onset, disease duration, Hoehn & Yahr stage, and treatment. Independent confirmation of these results could have implications for the clinical management of Parkinson's disease patients.
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Affiliation(s)
| | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Concha Bielza
- Computational Intelligence Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Pedro Larrañaga
- Computational Intelligence Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Alexandra Rizos
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - K Ray Chaudhuri
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
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Nogueira PJ, Forjaz MJ, Rodriguez-Blazquez C, Diaz-Franco A, Unim B, Palmieri L, Carcaillon-Bentata L, Makovski T, Feteira-Santos R. Research methodologies to assess the impact of COVID-19. Eur J Public Health 2021. [PMCID: PMC8574588 DOI: 10.1093/eurpub/ckab164.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
PHIRI WP5 aims at identifying the research approaches, data uses, pathways, indicators, and new methodologies to assess the impact of COVID-19 on Population Health.
Methods
Based on a collaborative work of researchers from 20 European institutions, several literature reviews were planned using automatized strategies to map the research methods analysing the impact of COVID-19 and data pathways: i) a scoping literature search to identify indicators of direct and indirect impact; ii) systematic literature reviews on determinants of severity for short and longterm health outcomes; and iii) a systematic literature review and meta-analysis to determine the effectiveness and impact of tracking COVID-19 patients using digitals tools.
Results
In November 2020, more than 73,000 papers about COVID-19 were published. About 16,000 (22%) reported data aspects, and approximately half reported both data aspects and methodologies. The most used indicators of direct impact are incidence and prevalence, mortality, severity and sequelae. To explore the etiological and prognostic effects of frailty, multimorbidity and socioeconomic status, the main identified outcomes were: infection, hospitalization, ICU admission, mortality by COVID-19 (etiological); as well as ICU admission, hospitalization, survival, functional decline, quality of life, disability, mental health difficulties and work absence (prognostic). The search generated 10,139 records. The initial literature search about mobile applications and electronic devices for tracking of COVID-19 patients yielded 2500 records.
Conclusions
The use of machine learning tools to synthesize the research about methods and data pathways on COVID-19 impact is feasible, as the amount of published evidence is very large. The vast amount of available literature on COVID-19 requires specific methods of literature search and synthesis, and an integrated effort of an extensive network of researchers.
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Affiliation(s)
- PJ Nogueira
- Área Disciplinar Autónoma da Bioestatística, Instituto de Medicina Preventiva e Saúde Pública, Lisbon, Portugal
- Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal
| | - MJ Forjaz
- National Center of Epidemiology, Health Institute Carlos III, Madrid, Spain
| | | | - A Diaz-Franco
- National Center of Epidemiology, Health Institute Carlos III, Madrid, Spain
| | - B Unim
- Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | - L Palmieri
- Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of Health, Rome, Italy
| | | | | | - R Feteira-Santos
- Área Disciplinar Autónoma da Bioestatística, Instituto de Medicina Preventiva e Saúde Pública, Lisbon, Portugal
- Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal
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17
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Thißen M, Bernal-Delgado E, Rodriguez-Blazquez C, Estupiñán-Romero F, Forjaz J, Gonzalez-García J, Lyons R, Schmidt A, Seeling S, Zeitlin J. Research use cases measuring the impact of COVID-19 on population health. Eur J Public Health 2021. [PMCID: PMC8574590 DOI: 10.1093/eurpub/ckab164.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Wide variations in COVID-19 infection and outcomes exist across Europe and within countries. PHIRI will look at COVID-19 impacts in specific subgroups by conducting research through use cases of immediate relevance for public health policies focusing on indirect effects of the pandemic related to healthcare and other policies to contain the pandemic. Furthermore, the use cases represent pilot activities for the benefits and added value of a research infrastructure by bringing together data from different European countries. Methods Four research use cases will focus on selected aspects of vulnerable population groups and risk factors, delayed medical care in cancer, perinatal health outcomes, as well as mental health outcomes and are selected based on public health importance, geographic coverage, feasibility of producing actionable insights and relevance for the PHIRI infrastructure. The use cases will demonstrate how a broad variety of secondary data (e.g. administrative and survey data) can be pooled and/or reused in a distributed way across Europe. Results The outputs of the use cases will be processed by formalizing data models, data management processes and analytical pipelines in an interoperable way to feed in the federated research infrastructure. The use cases facilitate research by making scalable, reproducible methods available within PHIRI and by publishing the FAIRified use cases analysis results on the Health Information Portal. They will provide outcomes to guide policy makers in preparedness and response scenarios and will ensure the development of a format for the timely dissemination of use case results to the targeted groups. Conclusions PHIRI will provide insights in real life use cases to generate immediate results on key health impacts of COVID-19 on population health to underpin decision making and will drive the development of the federated research infrastructure that allows rapid cycle analysis.
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Affiliation(s)
- M Thißen
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - E Bernal-Delgado
- Data Science for Health Services and Policy Research Group, Institute for Health Sciences in Aragon, Zaragoza, Spain
| | | | - F Estupiñán-Romero
- Data Science for Health Services and Policy Research Group, Institute for Health Sciences in Aragon, Zaragoza, Spain
| | - J Forjaz
- National Center of Epidemiology, Health Institute Carlos III, Madrid, Spain
| | - J Gonzalez-García
- Biocomputing Unit, Institute for Health Sciences in Aragon, Zaragoza, Spain
| | - R Lyons
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - A Schmidt
- Health Economics and Health Systems Analysis, Austrian Public Health Institute, Vienna, Austria
| | - S Seeling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - J Zeitlin
- Obstetrical, Perinatal and Pediatric Epidemiology Research, Center for Epidemiology and Statistics Sorbonne Paris Cité, Paris, France
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18
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Leta V, Urso D, Batzu L, Weintraub D, Titova N, Aarsland D, Martinez-Martin P, Borghammer P, van Wamelen DJ, Yousaf T, Rizos A, Rodriguez-Blazquez C, Chung-Faye G, Chaudhuri KR. Constipation is Associated with Development of Cognitive Impairment in de novo Parkinson's Disease: A Longitudinal Analysis of Two International Cohorts. J Parkinsons Dis 2021; 11:1209-1219. [PMID: 33843697 DOI: 10.3233/jpd-212570] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Constipation is regarded as one of the prodromal features of Parkinson's disease (PD) and there is emerging evidence linking gastrointestinal dysfunction and cognitive impairment (CI) in PD. OBJECTIVE We explored whether constipation is associated with development of CI in two independent cohorts of de novo PD patients (n = 196 from the Non-motor International Longitudinal Study [NILS] and n = 423 from the Parkinson's Progression Markers Initiative [PPMI] study). METHODS Constipation was clinically defined using the Non-Motor Symptoms Scale (NMSS) item-21 [NILS] and Scales for Outcomes in PD-Autonomic (SCOPA-AUT) item-5 [PPMI]. We assessed baseline group differences (PD with or without constipation) in CI, global non-motor symptoms burden, motor dysfunction, and striatal dopaminergic denervation. Kaplan-Meier method estimated group differences in cumulative proportion of patients with incident CI over three years. In PPMI, we subsequently performed univariate and multivariate Cox survival analyses to evaluate whether constipation predicts incident mild cognitive impairment or dementia over a 6-year period, including constipation and other known predictors of CI as covariates. RESULTS Patients with constipation had greater motor and global non-motor burden in both cohorts at baseline (p < 0.05). Kaplan-Meier plots showed faster conversion to CI in patients with constipation in both cohorts (p < 0.05). In PPMI, 37 subjects developed dementia during a mean follow-up of 4.9 years, and constipation was an independent predictor of dementia onset (hazard ratio = 2.311; p = 0.02). CONCLUSION Constipation in de novo PD patients is associated with development of cognitive decline and may serve as a clinical biomarker for identification of patients at risk for cognitive impairment.
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Affiliation(s)
- Valentina Leta
- Institute of Psychiatry, Psychology & Neuroscience, Department of Neurosciences, King's College London, London, United Kingdom.,Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Daniele Urso
- Institute of Psychiatry, Psychology & Neuroscience, Department of Neurosciences, King's College London, London, United Kingdom.,Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom.,Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari 'Aldo Moro', Tricase, Lecce, Italy
| | - Lucia Batzu
- Institute of Psychiatry, Psychology & Neuroscience, Department of Neurosciences, King's College London, London, United Kingdom.,Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | | | - Nataliya Titova
- Federal State Autonomous Educational Institution of Higher Education "N.I. Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation, Department of Neurology, Neurosurgery and Medical Genetics, Moscow, Russia.,Federal State Budgetary Institution "Federal Center of Brain and Neurotechnologies" of the Ministry of Health of the Russian Federation, Department of Neurodegenerative Diseases, Moscow, Russia
| | - Dag Aarsland
- Institute of Psychiatry, Psychology & Neuroscience, Department of Neurosciences, King's College London, London, United Kingdom.,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Pablo Martinez-Martin
- Centre for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Per Borghammer
- Institute for Clinical Medicine, Aarhus University, Aarhus, Denmark.,Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark
| | - Daniel J van Wamelen
- Institute of Psychiatry, Psychology & Neuroscience, Department of Neurosciences, King's College London, London, United Kingdom.,Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom.,Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Tayyabah Yousaf
- Institute of Psychiatry, Psychology & Neuroscience, Department of Neurosciences, King's College London, London, United Kingdom
| | - Alexandra Rizos
- Institute of Psychiatry, Psychology & Neuroscience, Department of Neurosciences, King's College London, London, United Kingdom.,Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | | | - Guy Chung-Faye
- Department of Gastroenterology, King's College Hospital Foundation NHS Trust, London, United Kingdom
| | - K Ray Chaudhuri
- Institute of Psychiatry, Psychology & Neuroscience, Department of Neurosciences, King's College London, London, United Kingdom.,Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
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19
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Rodriguez-Blazquez C, Forjaz MJ, Rodriguez-Violante M. Editorial: Measurement Tools for Clinical Assessment, Characterization and Neurorehabilitation of Parkinson's Disease. Front Neurol 2021; 12:700581. [PMID: 34122325 PMCID: PMC8193933 DOI: 10.3389/fneur.2021.700581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Maria João Forjaz
- National Epidemiology Center, Carlos III Health Institute, Madrid, Spain.,REDISSEC, Madrid, Spain
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20
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Romay-Barja M, Pascual-Carrasco M, De Tena-Dávila MJ, Falcón M, Rodriguez-Blazquez C, Forjaz MJ, Ayala A, Molina-de la Fuente I, Burgos A, Muñoz A, Benito A. How patients with COVID-19 managed the disease at home during the first wave in Spain: a cross-sectional study. BMJ Open 2021; 11:e048702. [PMID: 34016666 PMCID: PMC8137165 DOI: 10.1136/bmjopen-2021-048702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Most patients with mild COVID-19 had to stay at home trying to implement an optimal quarantine. The aim of this study was to describe the COVID-19 cases during the first wave of the pandemic in Spain, how they managed the disease at home, focusing on differences by age, as well as differences in knowledge, attitudes and preventive practices, compared with the uninfected population. DESIGN An online survey was used to conduct a cross-sectional study of individuals who were 14 years or older living in Spain during the COVID-19 lockdown. The main variable was a COVID-19 case. Logistic regression models for COVID-19 cases were obtained using a backward stepwise procedure to assess the association between social variables, disease knowledge, attitudes, prevention practices and emotional impact. RESULTS 3398 people completed the survey. Participants' mean age was 49.6 (SD=14.3). COVID-19 was significantly more prevalent among married people (5.3%) and those currently doing an on-site work (8.7%). Most of the COVID-19 cases stayed at home (84.0%) during the episode. There were significant age-based differences with regard to self-isolation conditions at home during the disease. COVID-19 cases showed better attitudes, practices and knowledge about disease symptoms and transmission than the uninfected population. COVID-19 cases also felt more depressed (adjusted OR: 3.46, 95% CI 1.45 to 8.26) and had better preventive behaviour than the uninfected population, such as always wearing a mask outside the home (adjusted OR 1.58, 95% CI 1.06 to 2.30). CONCLUSION COVID-19 cases found it difficult to comply with recommended home self-isolation conditions, with differences by age group. COVID-19 had an important impact on care dependency in non-hospitalised patients, who were mostly dependent on their families for care. It is necessary to reinforce social and health services and to be ready to meet the care needs of populations during the different waves or in future epidemics.
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Affiliation(s)
- María Romay-Barja
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain
- Red de Investigación Colaborativa en Enfermedades Tropicales, Madrid, Spain
| | | | | | - María Falcón
- Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain
| | | | - Maria João Forjaz
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Madrid, Spain
| | - Alba Ayala
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Madrid, Spain
- Instituto Universitario de Estudios de Género, Universidad Carlos III de Madrid - Campus de Leganes, Leganes, Spain
| | - Irene Molina-de la Fuente
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Biotecnología y Biomedicina, Universidad de Alcalá de Henares, Madrid, Spain
| | - Alfredo Burgos
- Unidad de Investigación en Salud Digital, Instituto de Salud Carlos III, Madrid, Spain
| | - Adolfo Muñoz
- Unidad de Investigación en Salud Digital, Instituto de Salud Carlos III, Madrid, Spain
| | - Agustin Benito
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain
- Red de Investigación Colaborativa en Enfermedades Tropicales, Madrid, Spain
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21
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van Wamelen DJ, Sauerbier A, Leta V, Rodriguez-Blazquez C, Falup-Pecurariu C, Rodriguez-Violante M, Rizos A, Tsuboi Y, Metta V, Bhidayasiri R, Bhattacharya K, Borgohain R, Prashanth LK, Rosales R, Lewis S, Fung V, Behari M, Goyal V, Kishore A, Lloret SP, Martinez-Martin P, Chaudhuri KR. Cross-sectional analysis of the Parkinson's disease Non-motor International Longitudinal Study baseline non-motor characteristics, geographical distribution and impact on quality of life. Sci Rep 2021; 11:9611. [PMID: 33953218 PMCID: PMC8100281 DOI: 10.1038/s41598-021-88651-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/12/2021] [Indexed: 01/20/2023] Open
Abstract
Growing evidence suggests that non-motor symptoms (NMS) in Parkinson’s disease (PD) have differential progression patterns that have a different natural history from motor progression and may be geographically influenced. We conducted a cross-sectional analysis of 1607 PD patients of whom 1327 were from Europe, 208 from the Americas, and 72 from Asia. The primary objective was to assess baseline non-motor burden, defined by Non-Motor Symptoms Scale (NMSS) total scores. Other aims included identifying the factors predicting quality of life, differences in non-motor burden between drug-naïve and non-drug-naïve treated patients, and non-motor phenotypes across different geographical locations. Mean age was 65.9 ± 10.8 years, mean disease duration 6.3 ± 5.6 years, median Hoehn and Yahr stage was 2 (2–3), and 64.2% were male. In this cohort, mean NMSS scores were 46.7 ± 37.2. Differences in non-motor burden and patterns differed significantly between drug-naïve participants, those with a disease duration of less than five years, and those with a duration of five years or over (p ≤ 0.018). Significant differences were observed in geographical distribution (NMSS Europe: 46.4 ± 36.3; Americas: 55.3 ± 42.8; Asia: 26.6 ± 25.1; p < 0.001), with differences in sleep/fatigue, urinary, sexual, and miscellaneous domains (p ≤ 0.020). The best predictor of quality of life was the mood/apathy domain (β = 0.308, p < 0.001). This global study reveals that while non-motor symptoms are globally present with severe NMS burden impacting quality of life in PD, there appear to be differences depending on disease duration and geographical distribution.
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Affiliation(s)
- Daniel J van Wamelen
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK. .,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands. .,Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Anna Sauerbier
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Neurology, Faculty of Medicine University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Valentina Leta
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology, Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Cristian Falup-Pecurariu
- Department of Neurology, Faculty of Medicine, County Emergency Clinic Hospital, Transilvania University, Braşov, Romania
| | | | - Alexandra Rizos
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | - Y Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Vinod Metta
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | | | - Kalyan Bhattacharya
- Formerly RG Kar Medical College and Institute of Neuroscience, Kolkata, India
| | | | - L K Prashanth
- Center for Parkinson's Disease and Movement Disorders Clinic, Vikram Hospitals, Bangalore, India.,Parkinson's Disease and Movement Disorders Clinic, Bangalore, India
| | | | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Victor Fung
- Movement Disorders Unit, Neurology Department, Westmead Hospital, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Madhuri Behari
- Department of Neurology, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Vinay Goyal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Asha Kishore
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Santiago Perez Lloret
- Biomedical Research Center, Interamerican Open University (CAECIHS-UAI), National Research Council (CONICET), Buenos Aires, Argentina.,Department of Physiology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
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22
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Oikonomou P, van Wamelen DJ, Weintraub D, Aarsland D, Ffytche D, Martinez-Martin P, Rodriguez-Blazquez C, Leta V, Borley C, Sportelli C, Trivedi D, Podlewska AM, Rukavina K, Rizos A, Lazcano-Ocampo C, Ray Chaudhuri K. Nonmotor symptom burden grading as predictor of cognitive impairment in Parkinson's disease. Brain Behav 2021; 11:e02086. [PMID: 33645912 PMCID: PMC8119808 DOI: 10.1002/brb3.2086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/27/2020] [Accepted: 01/31/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Identifying predictors of incident cognitive impairment (CI), one of the most problematic long-term outcomes, in Parkinson's disease (PD) is highly relevant for personalized medicine and prognostic counseling. The Nonmotor Symptoms Scale (NMSS) provides a global clinical assessment of a range of NMS, reflecting NMS burden (NMSB), and thus may assist in the identification of an "at-risk" CI group based on overall NMSB cutoff scores. METHODS To investigate whether specific patterns of PD NMS profiles predict incident CI, we performed a retrospective longitudinal study on a convenience sample of 541 nondemented PD patients taking part in the Nonmotor Longitudinal International Study (NILS) cohort, with Mini-Mental State Examination (MMSE), NMSS, and Scales for Outcomes in PD Motor Scale (SCOPA Motor) scores at baseline and last follow-up (mean 3.2 years) being available. RESULTS PD patients with incident CI (i.e., MMSE score ≤ 25) at last follow-up (n = 107) had severe overall NMSB level, significantly worse NMSS hallucinations/perceptual problems and higher NMSS attention/memory scores at baseline. Patients with CI also were older and with more advanced disease, but with no differences in disease duration, dopamine replacement therapy, sex, and comorbid depression, anxiety, and sleep disorders. CONCLUSIONS Our findings suggest that a comprehensive baseline measure of NMS and in particular hallucinations and perceptual problems assessed with a validated single instrument can be used to predict incident CI in PD. This approach provides a simple, holistic strategy to predict future CI in this population.
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Affiliation(s)
- Panteleimon Oikonomou
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK.,Department of Neurology and Neurophysiology, Medical Center-University of Freiburg, Freiburg, Germany
| | - Daniel J van Wamelen
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK.,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Daniel Weintraub
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Dominic Ffytche
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Carmen Rodriguez-Blazquez
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain.,National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | - Valentina Leta
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK
| | - Corinne Borley
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK
| | - Carolina Sportelli
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK
| | - Dhaval Trivedi
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK
| | - Aleksandra M Podlewska
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK
| | - Katarina Rukavina
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK
| | - Alexandra Rizos
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK
| | - Claudia Lazcano-Ocampo
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK.,Department of Neurology, Hospital Sotero del Río, Santiago de Chile, Chile
| | - Kallol Ray Chaudhuri
- Department of Neurosciences, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Parkinson Foundation Centre of Excellence at King's College Hospital, London, UK
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23
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Smilowska K, van Wamelen DJ, Pietrzykowski T, Calvano A, Rodriguez-Blazquez C, Martinez-Martin P, Odin P, Chaudhuri KR. Cost-Effectiveness of Device-Aided Therapies in Parkinson's Disease: A Structured Review. J Parkinsons Dis 2021; 11:475-489. [PMID: 33386813 PMCID: PMC8150660 DOI: 10.3233/jpd-202348] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background: Despite optimal dopaminergic treatment most patients in moderate to advanced stages of Parkinson’s disease (PD) experience progressively increasing disabilities, necessitating a shift from oral medication to device-aided therapies, including deep brain stimulation (DBS), intrajejunal levodopa-carbidopa infusion (IJLI), and continuous subcutaneous apomorphine infusion (CSAI). However, these therapies are costly, limiting their implementation. Objectives: To perform a systematic review on cost-effectiveness analyses for device-aided therapies in PD. Methods: References were identified by performing a systematic search in the PubMed and Web of Science databases in accordance with the PRISMA statement. In the absence of universal cost-effectiveness definitions, the gross domestic product per capita (GDP) in the country where a study was performed was used as a cut-off for cost-effectiveness based on cost per quality adjusted life year (QALY) gained. Results: In total 30 studies were retrieved. All device-aided therapies improved quality of life compared to best medical treatment, with improvements in QALYs between 0.88 and 1.26 in the studies with long temporal horizons. For DBS, nearly all studies showed that cost per QALY was below the GDP threshold. For infusion therapies only three studies showed a cost per QALY below this threshold, with several studies with long temporal horizons showing costs below or near the GDP threshold. Conclusion: Of the device-aided therapies, DBS can be considered cost-effective, but the majority of infusion therapy studies showed that these were less cost-effective. However, long-term use of the infusion therapies appears to improve their cost-effectiveness and in addition, several strategies are underway to reduce these high costs.
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Affiliation(s)
- Katarzyna Smilowska
- Silesian Center of Neurology, Katowice, Poland.,Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - Daniel J van Wamelen
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands.,Institute of Psychiatry, Psychology & Neuroscience, Department of Basic & Clinical Neuroscience, King's College London, London, United Kingdom.,Parkinson's Foundation Centre of Excellence at King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Tomasz Pietrzykowski
- Research Center for Public Policy and Regulatory Governance, Faculty of Law and Administration, University of Silesia, Katowice, Poland
| | - Alexander Calvano
- Institute of Psychiatry, Psychology & Neuroscience, Department of Basic & Clinical Neuroscience, King's College London, London, United Kingdom.,Parkinson's Foundation Centre of Excellence at King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology and Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Pablo Martinez-Martin
- National Center of Epidemiology and Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Per Odin
- University of Lund, Faculty of Medicine, Lund, Sweden
| | - K Ray Chaudhuri
- Institute of Psychiatry, Psychology & Neuroscience, Department of Basic & Clinical Neuroscience, King's College London, London, United Kingdom.,Parkinson's Foundation Centre of Excellence at King's College Hospital NHS Foundation Trust, London, United Kingdom
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Corchon S, Rodriguez-Blazquez C, Carvajal-Carrascal G, Fuentes-Ramirez A, Ruiz de Ocenda MI, Caparros N, Timonet-Andreu E, Navarta-Sanchez MV, Ambrosio L. International psychometric validation of the Living with Chronic Illness Scale in Spanish-speaking patients with chronic obstructive pulmonary disease. BMJ Open 2021; 11:e039973. [PMID: 33712522 PMCID: PMC7959234 DOI: 10.1136/bmjopen-2020-039973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/30/2020] [Accepted: 10/07/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To validate the Living with Chronic Illness (LW-CI) Scale in patients with chronic obstructive pulmonary disease (COPD). DESIGN Observational, cross-sectional validation study with retest. Acceptability, reliability, precision and construct validity were tested. SETTING The study took place in primary and secondary specialised units of public and private hospitals of Spain and Colombia. PARTICIPANTS The study included 612 patients with COPD assessed from May 2018 to May 2019. A consecutive cases sampling was done. Inclusion criteria included: (A) patients with a diagnosis of COPD; (B) native Spanish speaking; (C) able to read and understand questionnaires; and (D) able to provide informed consent. Exclusion criteria included: (A) cognitive deterioration and (B) pharmacological effect or disorder that could disrupt the assessment. RESULTS The LW-CI-COPD presented satisfactory data quality, with no missing data or floor/ceiling effects, showing high internal consistency for all the domains (Cronbach's alpha for the total score 0.92). Test-retest reliability was satisfactory (intraclass correlation coefficient=0.92). The LW-CI-COPD correlated 0.52-0.64 with quality of life and social support measures. The scale demonstrated satisfactory known-groups validity, yielding significantly different scores in patients grouped according to COPD severity levels. CONCLUSIONS This has been the first validation study of the LW-CI-COPD. It is a feasible, reliable, valid and precise self-reported scale to measure living with COPD in the Spanish-speaking population. Therefore, it could be recommended for research and clinical practice to measure this concept and evaluate the impact of centred-care interdisciplinary interventions based on the patients' perspective, focused on providing holistic and comprehensive care to patients with COPD.
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Affiliation(s)
- Silvia Corchon
- Faculty of Nursing and Chiropody, University of Valencia, Valencia, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology and Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas/CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | | | | | | | - Neus Caparros
- Faculty of Legal and Social Science, University of La Rioja, La Rioja, Spain
| | | | | | - Leire Ambrosio
- School of Health Sciences, NIHR ARC Wessex, University of Southampton, Southampton, UK
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25
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Ambrosio L, Perez-Manchon D, Carvajal-Carrascal G, Fuentes-Ramirez A, Caparros N, Ruiz de Ocenda MI, Timonet E, Navarta-Sanchez MV, Rodriguez-Blazquez C. Psychometric Validation of the Living with Chronic Illness Scale in Patients with Chronic Heart Failure. Int J Environ Res Public Health 2021; 18:ijerph18020572. [PMID: 33445479 PMCID: PMC7828024 DOI: 10.3390/ijerph18020572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/18/2020] [Accepted: 01/01/2021] [Indexed: 01/06/2023]
Abstract
It is necessary to develop self-reported instruments that evaluate the process of living with chronic heart failure (HF) holistically. The Living with Chronic Illness Scale—HF (LW-CI-HF) is the only available tool to evaluate how patients are living with HF. The aim is to analyse the psychometric properties of the LW-CI scale in the HF population. An international, cross-sectional validation study was carried out in 603 patients living with HF from Spain and Colombia. The variables measured were living with HF, perceived social support, satisfaction with life, quality of life and global impression of severity. The LW-CI-HF scale presented good data quality and acceptability. All domains showed high internal consistency with Cronbach’s alpha coefficient ≥ 0.7. The intraclass correlation coefficient for the total score was satisfactory (0.9) in test–retest reliability. The LW-CI-HF correlated 0.7 with social support and quality of life measures. Standard error of measurement was 6.5 for total scale. The LW-CI-HF scale is feasible, reliable and valid. However, results should be taken with caution in order to be used in clinical practice to evaluate the complex process of living with HF. Further research is proposed.
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Affiliation(s)
- Leire Ambrosio
- School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK
- Correspondence: ; Tel.: +44-(0)23-8059-7591
| | | | - Gloria Carvajal-Carrascal
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Bogotá 53753, Colombia; (G.C.-C.); (A.F.-R.)
| | - Alejandra Fuentes-Ramirez
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Bogotá 53753, Colombia; (G.C.-C.); (A.F.-R.)
| | - Neus Caparros
- Faculty of Legal and Social Science, La Rioja University, 26004 La Rioja, Spain;
| | | | - Eva Timonet
- Department of Cardiology, Costa del Sol Hospital, 29603 Malaga, Spain;
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26
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Rodriguez-Blazquez C, Schrag A, Rizos A, Chaudhuri KR, Martinez-Martin P, Weintraub D. Prevalence of Non-Motor Symptoms and Non-Motor Fluctuations in Parkinson's Disease Using the MDS-NMS. Mov Disord Clin Pract 2020; 8:231-239. [PMID: 33553493 DOI: 10.1002/mdc3.13122] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/06/2020] [Accepted: 11/14/2020] [Indexed: 12/16/2022] Open
Abstract
Background Non-motor symptoms (NMS) are frequent in Parkinson's disease (PD). Objectives To estimate the prevalence of NMS and of non-motor fluctuations (NMF) using the Movement Disorders Society-Non-Motor Rating Scale (MDS-NMS) and other scales assessing NMS, and their relationship with sex and PD severity. Methods Cross-sectional study with a sample of 402 PD patients. The Hoehn and Yahr staging system (HY), Clinical Impression of Severity Index for PD (CISI-PD), MDS-NMS (including NMF- subscale), Non-Motor Symptoms scale (NMSS), and MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) were applied. A NMS was considered present when scored ≥1. Differences in scores by sex and HY, CISI-PD, and MDS-UPDRS severity levels were calculated using Fisher's exact and chi-squared tests. Results Using the MDS-NMS, NMS were present in 99.7% of patients and the mean number of NMS was 16.13 (SD: 9.36). The most prevalent NMS was muscle, joint or back pain (67.4% of the sample) and the least prevalent was dopamine dysregulation syndrome (2.2%). Feeling sad or depressed was significantly more prevalent in women. Using the MDS-NMS revealed more NMS than the other scales assessing NMS. NMF were present in 41% of the sample, with fatigue being the most prevalent symptom (68.5% patients with NMF), and no differences by sex. Patients with greater PD severity had higher prevalence of NMS than patients with lower severity. Conclusions Almost all patients with PD experience NMS, and many experience NMF. Prevalence rates for NMS using the MDS-NMS are higher than on other scales used and increase with higher disease severity.
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Affiliation(s)
- Carmen Rodriguez-Blazquez
- National Centre of Epidemiology Carlos III Institute of Health Madrid Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED) Carlos III Institute of Health Madrid Spain
| | - Anette Schrag
- UCL Queen Square Institute of Neurology University College London London UK
| | - Alexandra Rizos
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson's Foundation Centre of Excellence King's College Hospital London UK
| | - K Ray Chaudhuri
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson's Foundation Centre of Excellence King's College Hospital London UK
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED) Carlos III Institute of Health Madrid Spain
| | - Daniel Weintraub
- Department of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia Department of Veterans Affairs Parkinson's Disease Research, Education and Clinical Center (PADRECC) Philadelphia Pennsylvania USA
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27
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Taghizadeh G, Rodriguez-Blazquez C, Joghataei MT, Goudarzi S, Habibi SAH, Bakhsheshi M, Mehdizadeh M, Fereshtehnejad SM. Psychometric features of Neuropathic Pain Symptom Inventory in Iranian people with Parkinson's disease. Neurol Sci 2020; 42:3233-3239. [PMID: 33241536 DOI: 10.1007/s10072-020-04941-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Neuropathic pain is a type of pain reported in people with Parkinson's disease. There are various scales to evaluate the characteristics of this kind of pain. The purpose of this study was to investigate the psychometric properties of the Neuropathic Pain Symptom Inventory (NPSI), a specific scale that measures neuropathic pain in Iranian people with Parkinson's disease. METHOD Four hundred forty-seven individuals with Parkinson's disease were recruited in the study. Acceptability, internal consistency (Cronbach's alpha), and test-retest reliability (intraclass correlation coefficient, ICC) of NPSI were calculated. Dimensionality was examined through exploratory factor analysis. For convergent validity, correlations of NPSI with Douleur Neuropathic 4, Brief Pain Inventory, King's Pain Parkinson disease Scale, and Visual Analog Scale-Pain were used. Discriminative validity and sensitivity to change between On- and Off- medication states were analyzed. RESULTS A marked floor effect was observed for this scale (64.2%). Cronbach's alpha and ICC were 0.90 and 0.87, respectively. Items of NPSI were placed in 4 factors. A moderate to the strong association (rs = 0.55 to 0.85) between NPSI and other scales was obtained. The results of discriminative validity and sensitivity to change indicate the ability of NPSI to show differences between medication states. CONCLUSION The results of this study suggest that NPSI has acceptable reliability, validity, and sensitivity to change, indicating that this scale is suitable for measuring neuropathic pain in Iranian people with Parkinson's disease.
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Affiliation(s)
- Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
| | | | - Mohammad Taghi Joghataei
- Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, 1449614535, Tehran, Iran.,Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Goudarzi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tehran University of Medical Science, Tehran, Iran
| | - Sayed Amir Hasan Habibi
- Department of Neurology, Rasoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Merat Bakhsheshi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Semnan University of Medical Science, Semnan, Iran
| | - Maryam Mehdizadeh
- Department of Neurosciences, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Shahid Hemmat Highway, 1449614535, Tehran, Iran. .,Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Seyed-Mohammad Fereshtehnejad
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.,Division of Neurology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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28
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Ambrosio L, Rodriguez-Blazquez C, Ayala A, Forjaz MJ. Rasch analysis of the living with chronic illness scale in Parkinson's disease. BMC Neurol 2020; 20:346. [PMID: 32933508 PMCID: PMC7493322 DOI: 10.1186/s12883-020-01926-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/09/2020] [Indexed: 02/07/2023] Open
Abstract
Background Neurologists play an essential role in facilitating the patient’s process of living with Parkinson’s disease (PD). The Living with Chronic Illness Scale-PD (LW-CI-PD) is a unique available clinical tool that evaluates how the patient is living with PD. The objective of the study was to analyse the LW-CI-PD properties according to the Rasch model. Methods An open, international, cross-sectional study was carried out in 324 patients with Parkinson’s disease from four Latin American countries and Spain. Psychometric properties of the LW-CI-PD were tested using Rasch analysis: fit to the Rasch model, item local independency, unidimensionality, reliability, and differential item functioning by age and gender. Results Original LW-CI-PD do not fit Rasch model. Modifications emerged included simplifying the response scale and deleting misfit items, the dimensions Acceptance, Coping and Integration showed a satisfactory fit to the Rasch model, with reliability indices greater than 0.70. The dimensions Self-management and Adjustment to the disease did not reach fit to the Rasch model. Conclusion Suggestions for improving the LW-CI-PD include a multidimensional and shorter scale with 12 items grouped in three subscales with a simpler response scheme. The final LW-CI-PD Scale version is a reliable scale, with good internal construct validity, that provides Rasch transformed results on linear metric scale.
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Affiliation(s)
- Leire Ambrosio
- Faculty of Nursing, University of Navarre, Campus Universitario s/n, 31009, Pamplona, Navarre, Spain.
| | | | - Alba Ayala
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Madrid, Spain
| | - Maria João Forjaz
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Madrid, Spain
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29
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Fleury V, Catalano Chiuvé S, Forjaz MJ, Di Marco M, Messe M, Debove I, Angulo J, Hariz GM, Burkhard PR, Martinez-Martin P, Rodriguez-Blazquez C, Krack P. Embarrassment and Shame in People With Parkinson's Disease: A New Tool for Self-Assessment. Front Neurol 2020; 11:779. [PMID: 32849230 PMCID: PMC7411180 DOI: 10.3389/fneur.2020.00779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
Shame and embarrassment related to Parkinson's disease (PD) are rarely addressed in clinical practice nor studied in neuroscience research, partly because no specific tool exists to detect them in PD. Objective: To develop a self-applied assessment tool of shame and embarrassment specifically related to PD or its treatment, to promptly identify the presence and severity of these two emotions in PD. Methods: Identification and selection of relevant items were obtained from the collection of PD patients' opinions during support groups and interviews. Several further items were added following a literature review. Subsequently, a two-phase pilot study was performed for identification of ambiguous items and omissions, and to obtain preliminary data on acceptability, reliability, validity and relevance of the new scale (SPARK). Results: A total of 105 PD patients were enrolled in the study. Embarrassment was reported in 85% of patients, while shame was present in 26%. Fifteen percent of patients did not describe any shame or embarrassment. On average, the intensity of these two emotions was low with a marked floor effect in SPARK items and subscales. However, SPARK total score inter-individual variability was important (range 1-84 out of 99). Acceptability and quality of data were satisfactory with no floor or ceiling effects (2.9% each) or missing data. Internal consistency (Cronbach's alpha) was 0.94 for total score and 0.73-0.87 for subscales. The scale correlated ≥0.60 with instruments measuring related constructs. Content validity was satisfactory. SPARK total score strongly correlated with impaired health-related quality of life (rS = 0.81), the propensity to feel embarrassed or ashamed (rS = 0.68 and 0.66, respectively), and anxiety (rS = 0.72) and depression (rS = 0.63) levels. Moderate to high correlations were observed between SPARK total score and apathy (rS = 0.46) and a more pronounced personality trait directed toward harm avoidance (rS = 0.46). No significant differences in SPARK scores were found by sex, education level, PD duration, Hoehn and Yahr stages or PD phenotype. Conclusion: Preliminary analysis of psychometric properties suggests that SPARK could be an acceptable and reliable instrument for assessing shame and embarrassment in PD. SPARK could help healthcare professionals to identify and characterize PD-induced shame and embarrassment.
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Affiliation(s)
- Vanessa Fleury
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | | | - Maria João Forjaz
- National Centre of Epidemiology, Carlos III Institute of Health, REDISSEC, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | | | - Maria Messe
- Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Ines Debove
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Julio Angulo
- Morningview Place, Lake Oswego, OR, United States.,Member, Persons With Parkinson's Advisory Council, Parkinson Foundation, Miami, FL, United States.,Member, Program Design Committee 2019 World Parkinson's Congress, World Parkinson's Coalition, New York, NY, United States
| | - Gun-Marie Hariz
- Department of Clinical Science, Neuroscience, Umeå University, Umeå, Sweden
| | - Pierre R Burkhard
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology, Carlos III Institute of Health, REDISSEC, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
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30
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Simon-Gozalbo A, Rodriguez-Blazquez C, Forjaz MJ, Martinez-Martin P. Clinical Characterization of Parkinson's Disease Patients With Cognitive Impairment. Front Neurol 2020; 11:731. [PMID: 32849203 PMCID: PMC7417300 DOI: 10.3389/fneur.2020.00731] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/15/2020] [Indexed: 12/27/2022] Open
Abstract
Background: Cognitive impairment is one of the most frequent and disabling non-motor symptoms in Parkinson disease (PD) and encompasses a continuum from mild cognitive impairment (PD-MCI) to dementia (PDD). The risk factors associated with them are not completely elucidated. Objective: To characterize the presence and clinical presentation of PD-MCI and PDD in patients with idiopathic PD, examining motor and non-motor features and determining factors associated with cognitive impairment. Methods: Multicenter, cross-sectional study in 298 PD patients who underwent clinical [Hoehn and Yahr (HY) staging and Clinical Impression of Severity Index for Parkinson Disease], neurological [Scales for Outcomes in Parkinson's Disease (SCOPA)-Motor], neuropsychological (Mini Mental State Examination, SCOPA-Cognition, Frontal Assessment Battery and Clinical Dementia Rating Scale), neuropsychiatric [SCOPA-Psychiatric complications, SCOPA-Psychosocial (SCOPA-PS), and Hospital Anxiety and Depression Scale (HADS)], and health-related quality of life [Parkinson Disease Questionnaire for quality of life (PDQ-8)] assessment. Movement Disorders Society criteria were applied to classify patients as normal cognition (NC), PD-MCI, and PDD. The association between variables was explored using multivariate binary and multinomial logistic regression models. Results: Seventy-two patients (24.2%) were classified as NC, 82 (27.5%) as PD-MCI, and 144 (48.3%) as PDD. These last two groups reported more psychosocial problems related with the disease (mean SCOPA-PS, 16.27 and 10.39, respectively), compared with NC (7.28) and lower quality-of-life outcomes (PDQ-8 48.98 and 28.42, respectively) compared to NC (19.05). The logistic regression analysis showed that both cognitive impaired groups had a more severe stage of PD measured by HY [odds ratio (OR) for MCI-PD, 2.45; 95% confidence interval (CI), 1.22-4.90; OR for PDD 2.64; 95% CI, 1.17-5.98]. Specifically, age (OR, 1.30; 95% CI, 1.16-1.47), years of education (OR, 0.91; 95% CI, 0.83-0.99), disease duration (OR, 1.19; 95% CI, 1.07-1.32), HADS-D (OR, 1.20; 95% CI, 1.06-1.35), and hallucinations (OR, 2.98; 95% CI, 1.16-7.69) were related to PDD. Conclusions: Cognitive impairment in PD is associated with more severe disease stage, resulting in a global, neuropsychiatric, psychosocial, and quality-of-life deterioration. This study provides a better understanding of the great impact that cognitive impairment has within the natural history of PD and its relationship with the rest of motor and non-motor symptoms in the disease.
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Affiliation(s)
- Ana Simon-Gozalbo
- Doctorate Program in Health Sciences, University of Alcala, Alcala de Henares, Spain
| | | | - Maria J Forjaz
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | - Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
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31
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Rodriguez-Blazquez C, João Forjaz M, Gimeno-Miguel A, Bliek-Bueno K, Poblador-Plou B, Pilar Luengo-Broto S, Guerrero-Fernández de Alba I, Maria Carriazo A, Lama C, Rodríguez-Acuña R, Cosano I, Bedoya JJ, Angioletti C, Carfì A, Di Paola A, Navickas R, Jureviciene E, Dambrauskas L, Liseckiene I, Valius L, Urbonas G, Onder G, Prados-Torres A. Assessing the Pilot Implementation of the Integrated Multimorbidity Care Model in Five European Settings: Results from the Joint Action CHRODIS-PLUS. Int J Environ Res Public Health 2020; 17:ijerph17155268. [PMID: 32707791 PMCID: PMC7432941 DOI: 10.3390/ijerph17155268] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/13/2020] [Accepted: 07/19/2020] [Indexed: 11/25/2022]
Abstract
Multimorbidity, the coexistence of several chronic conditions in a patient, represents a great challenge for healthcare systems and society. The Integrated Multimorbidity Care Model (IMCM) was recently designed within the Joint Action on chronic diseases and promoting healthy ageing across the life cycle (CHRODIS) to ensure the continuity of care for patients with multimorbidity. The IMCM was implemented in five European pilot sites in Spain, Italy, and Lithuania, within the Joint Action CHRODIS-PLUS. The effect of these pilot interventions was assessed pre- and post-implementation by 17 healthcare managers, using the Assessment of Chronic Illness Care (ACIC) measure, and by 226 patients with the Patient Assessment of Care for Chronic Conditions (PACIC+) survey. The ACIC total score significantly increased (5.23 to 6.71, p = 0.022) after the intervention, with differences across sites. A significant increase in the PACIC+ summary score was found ranging from 3.25 at baseline to 4.03 after the intervention (p < 0.001), and 58% of the sample perceived an improvement in care. Higher PACIC+ scores after the intervention were associated to lower baseline values in the respective PACIC+ dimension and to greater changes in ACIC Part 1 (delivery system organization). The IMCM implementation can help improve the quality of care for patients with multimorbidity.
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Affiliation(s)
| | - Maria João Forjaz
- National Centre of Epidemiology, Institute of Health Carlos III and REDISSEC, 28029 Madrid, Spain
- Correspondence:
| | - Antonio Gimeno-Miguel
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragon, REDISSEC, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (A.G.-M.); (B.P.-P.); (A.P.-T.)
| | - Kevin Bliek-Bueno
- Teaching Unit of Preventive Medicine and Public Health, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (K.B.-B.); (S.P.L.-B.); (I.G.-F.d.A.)
| | - Beatriz Poblador-Plou
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragon, REDISSEC, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (A.G.-M.); (B.P.-P.); (A.P.-T.)
| | - Sara Pilar Luengo-Broto
- Teaching Unit of Preventive Medicine and Public Health, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (K.B.-B.); (S.P.L.-B.); (I.G.-F.d.A.)
| | - Inmaculada Guerrero-Fernández de Alba
- Teaching Unit of Preventive Medicine and Public Health, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (K.B.-B.); (S.P.L.-B.); (I.G.-F.d.A.)
| | - Ana Maria Carriazo
- Regional Ministry of Health and Families of Andalusia, E-41020 Seville, Spain; (A.M.C.); (C.L.)
| | - Carmen Lama
- Regional Ministry of Health and Families of Andalusia, E-41020 Seville, Spain; (A.M.C.); (C.L.)
| | | | - Inmaculada Cosano
- Servicio Andaluz de Salud (SAS), San Jose de la Rinconada-Los Carteros Primary Care Center, E-41300 Seville, Spain;
| | - Juan José Bedoya
- Servicio Andaluz de Salud (SAS), Tiro de Pichon Primary Care Center, E-29006 Malaga, Spain;
| | - Carmen Angioletti
- Department of Internal Medicine and Geriatrics, Universita Cattolica del Sacro Cuore (UCSC), 00168 Rome, Italy; (C.A.); (A.D.P.)
| | - Angelo Carfì
- Centro di Medicina dell’Invecchiamento, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Antonella Di Paola
- Department of Internal Medicine and Geriatrics, Universita Cattolica del Sacro Cuore (UCSC), 00168 Rome, Italy; (C.A.); (A.D.P.)
| | - Rokas Navickas
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (R.N.); (E.J.); (L.D.)
- Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | - Elena Jureviciene
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (R.N.); (E.J.); (L.D.)
- Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | - Laimis Dambrauskas
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (R.N.); (E.J.); (L.D.)
- Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | - Ida Liseckiene
- Family Medicine Clinic, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, 50161 Kaunas, Lithuania; (I.L.); (L.V.); (G.U.)
- Department of Family Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Leonas Valius
- Family Medicine Clinic, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, 50161 Kaunas, Lithuania; (I.L.); (L.V.); (G.U.)
- Department of Family Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Gediminas Urbonas
- Family Medicine Clinic, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, 50161 Kaunas, Lithuania; (I.L.); (L.V.); (G.U.)
- Department of Family Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita, 0161 Rome, Italy;
| | - Alexandra Prados-Torres
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragon, REDISSEC, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (A.G.-M.); (B.P.-P.); (A.P.-T.)
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Pintér D, Forjaz MJ, Martinez-Martin P, Rodriguez-Blazquez C, Ayala A, Juhász A, Harmat M, Janszky J, Kovács N. Which Scale Best Detects Treatment Response of Tremor in Parkinsonism? J Parkinsons Dis 2019; 10:275-282. [PMID: 31868685 DOI: 10.3233/jpd-191800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Several scales are available for rating the severity of tremor at present. However, the sensitivity to change of these instruments has remained to be clarified. OBJECTIVE To compare the sensitivity of the Fahn-Tolosa-Marin Tremor Rating Scale, the Part III of the Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the MDS-UPDRS Tremor Scale to the effects of various antitremor treatments. METHODS Enrolling subjects with parkinsonism associated with tremor, we analyzed two scenarios: (1) tremor changes associated with acute levodopa challenge (n = 287) and (2) a 12-month outcome of different treatment options (n = 512) including deep brain stimulation (n = 146), levodopa/carbidopa intestinal gel infusion (n = 30), and initiating (n = 63) or adjusting oral antiparkinsonian medication (n = 273). Changes in tremor scales were assessed by effect size values (Cohen's d and eta-square). RESULTS Part B of the Fahn-Tolosa-Marin Tremor Rating Scale was the most sensitive to acute levodopa challenge (Cohen's d = -1.04, η2 = 0.12). However, Part A of the Fahn-Tolosa-Marin Tremor Rating Scale showed the highest effect size, which was a small one (Cohen's d = -0.33, η2 = 0.03), for detecting a treatment-related change in the severity of tremor during long-term follow-up. CONCLUSIONS The Fahn-Tolosa-Marin Tremor Rating Scale has a better ability to capture changes due to levodopa challenge or antiparkinsonian treatment than MDS-UPDRS Part III or MDS-UPDRS Tremor Scale.
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Affiliation(s)
- Dávid Pintér
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary.,Doctoral School of Clinical Neurosciences, University of Pécs, Pécs, Hungary
| | - Maria João Forjaz
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Spain
| | | | | | - Alba Ayala
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Spain
| | - Annamária Juhász
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary.,Doctoral School of Clinical Neurosciences, University of Pécs, Pécs, Hungary
| | - Márk Harmat
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary.,Doctoral School of Clinical Neurosciences, University of Pécs, Pécs, Hungary
| | - József Janszky
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Norbert Kovács
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
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Forjaz MJ, Rodriguez-Blazquez C, Guerrero-Fernández de Alba I, Gimeno-Miguel A, Bliek-Bueno K, Prados-Torres A. Application of the JA-CHRODIS Integrated Multimorbidity Care Model (IMCM) to a Case Study of Diabetes and Mental Health. Int J Environ Res Public Health 2019; 16:ijerph16245151. [PMID: 31861096 PMCID: PMC6950036 DOI: 10.3390/ijerph16245151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/08/2019] [Accepted: 12/12/2019] [Indexed: 01/29/2023]
Abstract
The Integrated Multimorbidity Care Model (IMCM), developed by the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), proposes a set of 16 multidimensional components (i.e., recommendations) to improve the care of persons with multimorbidity in Europe. This study aimed at analyzing the potential applicability of the IMCM. We followed a qualitative approach that comprised two phases: (1) The design of a case study based on empirical clinical data, which consisted of a hypothetical woman with multimorbidity, type 2 diabetes mellitus, mental health, and associated social problems, and (2) the creation of a consensus group to gather the opinions of a multidisciplinary group of experts and consider the potential applicability of the IMCM to our case study. Experts described how care should be delivered to this patient according to each model component, suggested the use of specific rating scales and tools to assess her needs in a comprehensive and regular way, and pointed our crucial health and social resources to improve her care process. Experts also highlighted patient-centered, integrated and tailored care as one of the keystones of quality healthcare. Our results suggest that the IMCM is applicable in complex patients with multimorbidity.
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Affiliation(s)
- Maria João Forjaz
- Department of Epidemiology and Biostatistics, National School of Public Health and REDISSEC. Carlos III Institute of Health, 28029 Madrid, Spain;
| | | | | | - Antonio Gimeno-Miguel
- EpiChron Research Group, Aragon Health Sciences Institute, IIS Aragón, REDISSEC, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (A.G.-M.); (A.P.-T.)
| | - Kevin Bliek-Bueno
- EpiChron Research Group, IIS Aragón, Teaching Unit of Preventive Medicine and Public Health, 50009 Zaragoza, Spain;
| | - Alexandra Prados-Torres
- EpiChron Research Group, Aragon Health Sciences Institute, IIS Aragón, REDISSEC, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (A.G.-M.); (A.P.-T.)
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Palmer K, Carfì A, Angioletti C, Di Paola A, Navickas R, Dambrauskas L, Jureviciene E, João Forjaz M, Rodriguez-Blazquez C, Prados-Torres A, Gimeno-Miguel A, Cano-del Pozo M, Bestué-Cardiel M, Leiva-Fernández F, Poses Ferrer E, Carriazo AM, Lama C, Rodríguez-Acuña R, Cosano I, Bedoya-Belmonte JJ, Liseckiene I, Barbolini M, Txarramendieta J, de Manuel Keenoy E, Fullaondo A, Rijken M, Onder G. A Methodological Approach for Implementing an Integrated Multimorbidity Care Model: Results from the Pre-Implementation Stage of Joint Action CHRODIS-PLUS. Int J Environ Res Public Health 2019; 16:ijerph16245044. [PMID: 31835691 PMCID: PMC6950053 DOI: 10.3390/ijerph16245044] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 11/27/2019] [Accepted: 12/01/2019] [Indexed: 11/16/2022]
Abstract
Patients with multimorbidity (defined as the co-occurrence of multiple chronic diseases) frequently experience fragmented care, which increases the risk of negative outcomes. A recently proposed Integrated Multimorbidity Care Model aims to overcome many issues related to fragmented care. In the context of Joint Action CHRODIS-PLUS, an implementation methodology was developed for the care model, which is being piloted in five sites. We aim to (1) explain the methodology used to implement the care model and (2) describe how the pilot sites have adapted and applied the proposed methodology. The model is being implemented in Spain (Andalusia and Aragon), Lithuania (Vilnius and Kaunas), and Italy (Rome). Local implementation working groups at each site adapted the model to local needs, goals, and resources using the same methodological steps: (1) Scope analysis; (2) situation analysis—“strengths, weaknesses, opportunities, threats” (SWOT) analysis; (3) development and improvement of implementation methodology; and (4) final development of an action plan. This common implementation strategy shows how care models can be adapted according to local and regional specificities. Analysis of the common key outcome indicators at the post-implementation phase will help to demonstrate the clinical effectiveness, as well as highlight any difficulties in adapting a common Integrated Multimorbidity Care Model in different countries and clinical settings.
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Affiliation(s)
- Katie Palmer
- Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00136 Rome, Italy;
- Correspondence:
| | - Angelo Carfì
- Centro di Medicina dell’Invecchiamento, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00136 Rome, Italy
| | - Carmen Angioletti
- Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore and Centro di Medicina dell’Invecchiamento, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00136 Rome, Italy;
| | - Antonella Di Paola
- Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00136 Rome, Italy;
| | - Rokas Navickas
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (R.N.); (L.D.); (E.J.)
- Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | - Laimis Dambrauskas
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (R.N.); (L.D.); (E.J.)
- Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | - Elena Jureviciene
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania; (R.N.); (L.D.); (E.J.)
- Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | - Maria João Forjaz
- National School of Public Health and REDISSEC, Carlos III Institute of Health, ES-28029 Madrid, Spain;
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, ES-28029 Madrid, Spain;
| | - Alexandra Prados-Torres
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, REDISSEC, 50009 Zaragoza, Spain; (A.P.-T.); (A.G.-M.)
| | - Antonio Gimeno-Miguel
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, REDISSEC, 50009 Zaragoza, Spain; (A.P.-T.); (A.G.-M.)
| | - Mabel Cano-del Pozo
- General Directorate of Healthcare, Health Department, 50017 Zaragoza, Spain; (M.C.-d.P.); (M.B.-C.)
| | - María Bestué-Cardiel
- General Directorate of Healthcare, Health Department, 50017 Zaragoza, Spain; (M.C.-d.P.); (M.B.-C.)
| | - Francisca Leiva-Fernández
- Málaga-Guadalhorce Primary Care Teaching Unit, IBIMA, Andalusian Health Service, 29009 Málaga, Spain;
| | - Elisa Poses Ferrer
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Government of Catalonia, 08005 Barcelona, Spain;
| | - Ana M Carriazo
- Regional Ministry of Health and Families of Andalusia (CSFJA), E-41020 Seville, Spain; (A.M.C.); (C.L.)
| | - Carmen Lama
- Regional Ministry of Health and Families of Andalusia (CSFJA), E-41020 Seville, Spain; (A.M.C.); (C.L.)
| | | | - Inmaculada Cosano
- San José de la Rinconada-Los Carteros Primary Care Center, Andalusian Health Service (Servicio Andaluz de Salud, SAS), E-41300 Seville, Spain
| | - Juan José Bedoya-Belmonte
- Tiro de Pichón Primary Care Center, Andalusian Health Service (Servicio Andaluz de Salud, SAS), E-29006 Málaga, Spain;
| | - Ida Liseckiene
- Faculty of Medicine, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania;
| | | | - Jon Txarramendieta
- Kronikgune Institute for Health Services Research, 48902 Basque Country, Spain; (J.T.); (E.d.M.K.); (A.F.)
| | - Esteban de Manuel Keenoy
- Kronikgune Institute for Health Services Research, 48902 Basque Country, Spain; (J.T.); (E.d.M.K.); (A.F.)
| | - Ane Fullaondo
- Kronikgune Institute for Health Services Research, 48902 Basque Country, Spain; (J.T.); (E.d.M.K.); (A.F.)
| | - Mieke Rijken
- Nivel (Netherlands Institute for Health Services Research), 3513 CR Utrecht, The Netherlands;
- Department of Health and Social Management, University of Eastern Finland, FI-70210 Kuopio, Finland
| | - Graziano Onder
- Department of Cardiovascular, Metabolic and Aging Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
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Balestrino R, Hurtado-Gonzalez CA, Stocchi F, Radicati FG, Chaudhuri KR, Rodriguez-Blazquez C, Martinez-Martin P. Applications of the European Parkinson's Disease Association sponsored Parkinson's Disease Composite Scale (PDCS). NPJ Parkinsons Dis 2019; 5:26. [PMID: 31798050 PMCID: PMC6881347 DOI: 10.1038/s41531-019-0097-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/18/2019] [Indexed: 12/31/2022]
Abstract
This study was addressed to determine the presence of Parkinson disease (PD) manifestations, their distribution according to motor subtypes, and the relationships with health-related quality of life (QoL) using the recently validated European Parkinson’s Disease Association sponsored Parkinson’s Disease Composite Scale (PDCS). Frequency of symptoms was determined by the scores of items (present if >0). Using ROC analysis and Youden method, MDS-UPDRS motor subtypes were projected on the PDCS to achieve a comparable classification based on the PDCS scores. The same method was used to estimate severity levels from other measures in the study. The association between the PDCS and QoL (PDQ-39) was analyzed by correlation and multiple linear regression. The sample consisted of 776 PD patients. We found that the frequency of PD manifestations with PDCS and MDS-UPDRS were overlapping, the average difference between scales being 5.5% only. Using the MDS-UPDRS subtyping, 215 patients (27.7%) were assigned as Tremor Dominant (TD), 60 (7.7%) Indeterminate, and 501 (64.6%) Postural Instability and Gait Difficulty (PIGD) in this cohort. With this classification as criterion, the analogous PDCS-based ratio provided these cut-off values: TD subtype, ≥1.06; Indeterminate, <1.06 but >0.65; and PIGD, <0.65. The agreement between the two scales on this classification was substantial (87.6%; kappa = 0.69). PDCS total score cut-offs for PD severity were: 23/24 for mild/moderate and 41/42 for moderate/severe. Moderate to high correlations (r = 0.35–0.80) between PDCS and PDQ-39 were obtained, and the four PDCS domains showed a significant independent influence on QoL. The conclusions are: (1) the PDCS assessed the frequency of PD symptoms analogous to the MDS-UPDRS; (2) motor subtypes and severity levels can be determined with the PDCS; (3) a significant association between PDCS and QoL scores exists.
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Affiliation(s)
| | - Carlos Alberto Hurtado-Gonzalez
- 2Facultad de Psicología, Universidad Cooperativa de Colombia, Seccional Cali, and Facultad de Medicina, Universidad Libre, Cali, Colombia
| | - Fabrizio Stocchi
- 3Institute for Research and Medical Care, IRCCS, San Raffaele, Rome, Italy
| | | | - K Ray Chaudhuri
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF UK.,5Parkinson Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, SE5 9RS UK
| | | | - Pablo Martinez-Martin
- 6National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
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Chaudhuri KR, Schrag A, Weintraub D, Rizos A, Rodriguez-Blazquez C, Mamikonyan E, Martinez-Martin P. The movement disorder society nonmotor rating scale: Initial validation study. Mov Disord 2019; 35:116-133. [PMID: 31571279 DOI: 10.1002/mds.27862] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/02/2019] [Accepted: 08/23/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The Movement Disorder Society-sponsored Nonmotor Rating Scale is an update of the existing Parkinson's disease Nonmotor Symptoms Scale modified to address some limitations in Nonmotor Symptoms Scale scoring, structure, and symptom coverage. METHODS PD patients were recruited from movement disorder centers in an international, multicenter study. The Movement Disorder Society Nonmotor Rating Scale, consisting of 13 domains plus a subscale for nonmotor fluctuations, was rater administered, along with the Nonmotor Symptoms Scale and other clinical assessments. Standard reliability and validity testing were conducted. RESULTS Four hundred and two PD patients were recruited (mean age ± standard deviation, 67.42 ± 9.96 years; mean age at PD onset ± standard deviation, 59.27 ± 10.67 years; median Hoehn and Yahr stage 2 (interquartile range 2-3). Data quality was satisfactory for all Movement Disorder Society Nonmotor Rating Scale domains except sexual (6.7% missing data). There were no floor or ceiling effects for the Movement Disorder Society Nonmotor Rating Scale and nonmotor fluctuations total score; domains had no ceiling effects, but some floor effects (13.5%-83.5%). The Movement Disorder Society Nonmotor Rating Scale and nonmotor fluctuations total score internal consistency were acceptable (average Cronbach's alpha, 0.66 and 0.84, respectively); interrater reliability was excellent (intraclass correlation coefficient, >0.95); for test-retest reliability, the intraclass correlation coefficient was 0.84 for the Movement Disorder Society Nonmotor Rating Scale and 0.70 for Movement Disorder Society nonmotor fluctuations total score, and precision was excellent for the Movement Disorder Society Nonmotor Rating Scale (standard error of measurement, 25.30) and fair for nonmotor fluctuations (standard error of measurement, 7.06). Correlations between Movement Disorder Society Nonmotor Rating Scale score and the corresponding Nonmotor Symptoms Scale and Movement Disorder Society UPDRS scores were high. There were no significant sex or age effects. The Movement Disorder Society Nonmotor Rating Scale score increased with increasing PD duration, disease severity, and PD medication dose (all P < 0.001). CONCLUSIONS The Movement Disorder Society Nonmotor Rating Scale is a valid measure for measuring the burden of a wide range of Nonmotor Rating Scale scores, including nonmotor fluctuations, in PD patients. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- K Ray Chaudhuri
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Daniel Weintraub
- Department of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Alexandra Rizos
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | | | - Eugenia Mamikonyan
- Department of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
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Klingelhoefer L, Chaudhuri KR, Kamm C, Martinez-Martin P, Bhatia K, Sauerbier A, Kaiser M, Rodriguez-Blazquez C, Balint B, Untucht R, Hall LJ, Mildenstein L, Wienecke M, Martino D, Gregor O, Storch A, Reichmann H. Validation of a self-completed Dystonia Non-Motor Symptoms Questionnaire. Ann Clin Transl Neurol 2019; 6:2054-2065. [PMID: 31560179 PMCID: PMC6801169 DOI: 10.1002/acn3.50900] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 08/19/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To develop and validate a novel 14-item self-completed questionnaire (in English and German) enquiring about the presence of non-motor symptoms (NMS) during the past month in patients with craniocervical dystonia in an international multicenter study. METHODS The Dystonia Non-Motor Symptoms Questionnaire (DNMSQuest) covers seven domains including sleep, autonomic symptoms, fatigue, emotional well-being, stigma, activities of daily living, sensory symptoms. The feasibility and clinimetric attributes were analyzed. RESULTS Data from 194 patients with CD (65.6% female, mean age 58.96 ± 12.17 years, duration of disease 11.95 ± 9.40 years) and 102 age- and sex-matched healthy controls (66.7% female, mean age 55.67 ± 17.62 years) were collected from centres in Germany and the UK. The median total NMS score in CD patients was 5 (interquartile range 3-7), significantly higher than in healthy controls with 1 (interquartile range 0.75-2.25) (P < 0.001, Mann-Whitney U-test). Evidence for intercorrelation and convergent validity is shown by moderate to high correlations of total DNMSQuest score with motor symptom severity (TWSTRS: rs = 0.61), clinical global impression (rs = 0.40), and health-related quality of life measures: CDQ-24 (rs = 0.74), EQ-5D index (rs = -0.59), and scale (rs = -0.49) (all P < 0.001). Data quality and acceptability was very satisfactory. INTERPRETATION The DNMSQuest, a patient self-completed questionnaire for NMS assessment in CD patients, appears robust, reproducible, and valid in clinical practice showing a tangible impact of NMS on quality of life in CD. As there is no specific, comprehensive, validated tool to assess the burden of NMS in dystonia, the DNMSQuest can bridge this gap and could easily be integrated into clinical practice.
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Affiliation(s)
| | - Kallol R Chaudhuri
- National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, United Kingdom
| | - Christoph Kamm
- Department of Neurology, University of Rostock, Rostock, Germany.,German Centre for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Pablo Martinez-Martin
- National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | - Kailash Bhatia
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
| | - Anna Sauerbier
- National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, United Kingdom
| | - Maximilian Kaiser
- Department of Neurology, Technical University Dresden, Dresden, Germany
| | | | - Bettina Balint
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom.,Department of Neurology, University Hospital, Heidelberg, Germany
| | - Robert Untucht
- Department of Neurology, Technical University Dresden, Dresden, Germany
| | - Lynsey J Hall
- National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, United Kingdom
| | | | - Miriam Wienecke
- Department of Neurology, Technical University Dresden, Dresden, Germany
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary & Hotchkiss Brain Institute, Calgary, Canada
| | - Olaf Gregor
- Department of Neurology, Klinikum Chemnitz, Chemnitz, Germany
| | - Alexander Storch
- Department of Neurology, University of Rostock, Rostock, Germany.,German Centre for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Heinz Reichmann
- Department of Neurology, Technical University Dresden, Dresden, Germany
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de Rooy FBB, Buhmann C, Schönwald B, Martinez-Martin P, Rodriguez-Blazquez C, Putter H, Elzevier HW, van der Plas AA. Discussing sexuality with Parkinson's disease patients: a multinational survey among neurologists. J Neural Transm (Vienna) 2019; 126:1273-1280. [PMID: 31396705 PMCID: PMC6765045 DOI: 10.1007/s00702-019-02053-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/24/2019] [Indexed: 01/23/2023]
Abstract
Sexual dysfunction is a major non-motor feature of Parkinson’s disease (PD) that may affect the quality of life of many patients. In a Dutch survey, we demonstrated that neurologists often fail to discuss sexuality with their patients. Our objective was to determine to which extent neurologists in Spain and Germany address sexuality with their patients and whether cross-cultural differences exist. A 30-item questionnaire was sent out to 1650 German and 460 Spanish neurologists. The questionnaire addressed attitudes, knowledge, barriers, and feelings of responsibility regarding sexuality in PD. 160 German and 32 Spanish respondents completed and returned the questionnaire. The majority of German and Spanish participants discuss sexual dysfunction ‘regularly’ with male patients (61.7% and 78.9%, respectively), but ‘seldom’ with female patients (68.8% and 78.1%, respectively). Important barriers for German and Spanish respondents to discuss sexual dysfunction were patients not expressing sexual complaints spontaneously (52.9% and 75.0%, respectively) and insufficient consultation time (32.2% and 71.9%, respectively). Sexual dysfunction in PD was considered important by 68.3% of German and 96.9% of Spanish participants. German and Spanish neurologists do not routinely discuss sexual dysfunction with their patients, although many of them consider it important to address this topic. It is unclear why this lack of discussing sexual dysfunction is especially found for female patients and whether cultural aspects are involved. We recommend a self-assessment tool for patients to track their symptoms prior to consultation visits and advocate local guidelines that formulate who is responsible for discussing sexual dysfunction.
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Affiliation(s)
- F B B de Rooy
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
| | - C Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, 20246, Hamburg, Germany
| | - B Schönwald
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, 20246, Hamburg, Germany
| | - P Martinez-Martin
- National Center of Epidemiology and CIBERNED, Institute of Health Carlos III, Madrid, Spain
| | - C Rodriguez-Blazquez
- National Center of Epidemiology and CIBERNED, Institute of Health Carlos III, Madrid, Spain
| | - H Putter
- Department of Medical Statistics, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - A A van der Plas
- Department of Neurology, Alrijne Hospital, Simon Smitweg 1, 2353 GA, Leiderdorp, The Netherlands
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Martinez-Martin P, Wetmore JB, Arbelo JM, Catalán MJ, Valldeoriola F, Rodriguez-Blazquez C. Validation study of the Parkinson's Fatigue Scale in advanced Parkinson's disease. Patient Relat Outcome Meas 2019; 10:141-152. [PMID: 31114412 PMCID: PMC6497829 DOI: 10.2147/prom.s196042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/12/2019] [Indexed: 11/29/2022]
Abstract
Purpose: To validate the Parkinson’s Fatigue Scale (PFS-16) in advanced Parkinson Disease (APD) patients using the scale’s Spanish version. Patients and methods: In a clinical study for Levodopa-Carbidopa Intestinal Gel (LCIG), 59 patients were assessed over six months using the PFS-16 and other instruments. The psychometric properties of the PFS-16 were then analyzed. Results: Patients (60.7% men) were aged 68.02±7.43 years. PD duration was 12.57±5.97 years. Median Hoehn and Yahr (HY) stage of patients in “on” was 2 (range: 1–4). There were excellent data quality and acceptability for the PFS-16 as a whole, except for moderate-to-high ceiling effects in its items. Two factors explained 67% of the variance, yet parallel analysis demonstrated the unidimensional nature of the PFS-16, whose internal consistency was satisfactory (Cronbach’s alpha=0.93; item homogeneity coefficient=0.19, and item total-corrected correlations=0.50–0.84). PFS-16 total score showed moderate-to-high correlations with fatigue-specific questions within clinical tools, namely item 20 of the Beck Depression Inventory (rS=0.65) and item 4 of the Non-Motor Symptoms Scale (rS=0.33). Weak-to-moderate correlations were observed between the PFS-16 and measures of anxiety, depression, apathy, and quality of life. There were no significant differences in PFS-16 total scores when grouped by age, sex, time from diagnosis, HY, and CGI-S. After treatment with LCIG, the relative change in PFS-16 total score was −17.6% and the effect size (Cohen’s d) was 0.92. Moderate correlations between changes in the PFS-16 and several other clinical tools were also found. Conclusion: In APD patients, the PFS-16 showed satisfactory acceptability, internal consistency, construct validity, and responsiveness.
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Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - John B Wetmore
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - José Matías Arbelo
- Movement Disorders Unit, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | | | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
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Ambrosio L, Portillo MC, Rodriguez-Blazquez C, Rojo JM, Martinez-Martin P. Influencing factors when living with Parkinson's disease: A cross-sectional study. J Clin Nurs 2019; 28:3168-3176. [PMID: 30938889 DOI: 10.1111/jocn.14868] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 03/06/2019] [Accepted: 03/23/2019] [Indexed: 01/13/2023]
Abstract
AIMS AND OBJECTIVES To identify the personal- and disease-related factors that are associated with living with Parkinson's disease. BACKGROUND Living with Parkinson's disease affects the physical, psychological, social and spiritual areas of the person. Health professionals need to know which factors influence the daily living with Parkinson's disease, in order to facilitate a positive living. DESIGN A multicentre cross-sectional study. METHODS A total of 324 patients with Parkinson's disease diagnoses were included in the study through a consecutive case sampling. Data were collected from January-June 2015, in specialised units of movement disorders of public and private and community centres, from Spain, Argentina, Mexico, Ecuador and Cuba. Nine measures were applied to evaluate personal-related factors (age, gender, psychosocial function, satisfaction with life, social support, home economical situation) and Parkinson's disease-related factors (duration of disease, motor symptoms and non-motor symptoms). The STROBE checklist was used to ensure quality reporting during the study (see File S1). Multiple linear regression analysis was carried out. RESULTS Results indicated that social support, followed by satisfaction with life and home economical situation are the only three factors that significantly influence in living with Parkinson's disease. The rest of the factors analysed did not present significant influence in the daily living with this neurodegenerative disease. CONCLUSION This study highlights the necessity to put more emphasis on the person and his/her daily living with the condition and less on symptoms and treatment. Health professionals need to develop person-centred interventions that also deal with other elements of the experience of living with a long-term condition like Parkinson's disease. RELEVANCE TO CLINICAL PRACTICE Interventions to foster positive living with Parkinson's disease in clinical practice should integrate strategies to tackle and prevent loneliness and interagency elements to increase community resources and systems of support.
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Affiliation(s)
- Leire Ambrosio
- Faculty of Nursing, University of Navarre, Pamplona, Spain
| | | | | | - Jose Manuel Rojo
- Department of Statistics, Center of Human and Social Sciences, Spanish Council for Scientific Research, Madrid, Spain
| | - Pablo Martinez-Martin
- National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
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Martinez-Martin P, Schrag A, Weintraub D, Rizos A, Rodriguez-Blazquez C, Chaudhuri KR. Pilot Study of the International Parkinson and Movement Disorder Society-sponsored Non-motor Rating Scale (MDS-NMS). Mov Disord Clin Pract 2019; 6:227-234. [PMID: 30949554 DOI: 10.1002/mdc3.12728] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/07/2018] [Accepted: 01/06/2019] [Indexed: 01/01/2023] Open
Abstract
Background Non-motor symptoms (NMS) are integral to Parkinson's disease (PD) and have a detrimental effect on patients and their caregivers. Clinical quantification has been aided by the development of comprehensive assessments such as the Non-Motor Symptoms Questionnaire (NMSQuest) and Scale (NMSS). The NMSS has been widely used in clinical studies and trials; however, since its validation in 2007, our understanding of NMS has changed substantially. With the support of the International Parkinson and Movement Disorder Society (IPMDS), after a detailed peer review an initiative to develop an updated version of NMSS, the MDS-NMS was launched in 2015. Objective This paper encapsulates the data from the pre-validation phases carried out under the auspices of the IPMDS Non-Motor PD Study Group. Methods Item selection and wording (formatted as a rater-based tool) were based on the NMSS, literature review, and expert consensus. Neurologists, PD patients, and healthy controls were included in the cognitive pretesting and administration of the preliminary version of the MDS-NMS. Primary data on acceptability and reliability were obtained. Results The pilot study, carried out in English in the United Kingdom and the United States, demonstrated that the preliminary version of the MDS-NMS was comprehensive, understandable, and appropriate. Data quality was excellent; moderate floor effect was present in patients for most MDS-MNS domains, with some components showing weak internal consistency. The results led to additional instrument modifications. Conclusion Qualitative and quantitative research results have led to an updated NMSS, the definitive version of the MDS-NMS, which is currently being validated.
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Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED Carlos III Institute of Health Madrid Spain
| | - Anette Schrag
- Department of Clinical Neurosciences, Royal Free Campus Institute of Neurology University College London London United Kingdom
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA.,Parkinson's Disease Research Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center Philadelphia Pennsylvania USA
| | - Alexandra Rizos
- Parkinson's Foundation International Centre of Excellence King's College Hospital London United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience King's College London London United Kingdom
| | | | - Kallol Ray Chaudhuri
- Parkinson's Foundation International Centre of Excellence King's College Hospital London United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience King's College London London United Kingdom
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Wijers IGM, Ayala A, Rodriguez-Blazquez C, Rodriguez-Laso A, Rodriguez-García P, Prados-Torres A, Rodriguez-Rodriguez V, Forjaz MJ. The Disease Burden Morbidity Assessment in older adults and its association with mortality and other health outcomes. Eur J Ageing 2018; 16:193-203. [PMID: 31139033 DOI: 10.1007/s10433-018-0491-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The objective of this study was to assess how disease burden caused by chronic conditions is related to mortality (predictive validity) and other health outcomes (convergent validity). This was studied in 625 community-dwelling adults living in Spain aged 65 years and older. Disease burden was measured with the Disease Burden Morbidity Assessment (DBMA). The association with 5-year mortality was assessed using a Cox model and Kaplan-Meier curves. For convergent validity, mean age, sex ratio, patient-centered outcomes and healthcare utilization were compared for high and low DBMA scores (< 10 vs. ≥ 10). Also, a multivariable linear regression model was used to evaluate the DBMA as a function of these variables. Mean DBMA score in our sample was 7.5. After 5 years, 35 participants had died (5.5%). The Cox model displayed a hazard ratio of 1.07, and the Kaplan-Meier curves showed lower survival for high DBMA scores. Among participants with high DBMA scores, low self-perceived health, disability and female sex were more frequent, and this group showed lower mean scores for quality of life (Personal Wellbeing Index), affect balance (Scale of Positive and Negative Experience) and physical activity (Yale Physical Activity Survey), higher mean age and higher healthcare utilization than persons with low DBMA scores. In the multivariable regression, all variables but age were significantly associated with the DBMA. In conclusion, the DBMA showed satisfactory predictive and convergent validity. In our aging society, it can be applied to better understand and improve care for older persons with multiple chronic conditions.
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Affiliation(s)
- Irene G M Wijers
- 1Department of Preventive Medicine and Quality Management, General University Hospital Gregorio Marañón, Madrid, Spain
| | - Alba Ayala
- 2National School of Public Health, Institute of Health Carlos III and REDISSEC, Avda. Monforte de Lemos 5, 28029 Madrid, Spain
| | | | - Angel Rodriguez-Laso
- Biomedical Research Foundation of the University Hospital of Getafe, Madrid, Spain
| | | | - Alexandra Prados-Torres
- Aragón Health Sciences Institute (IACS), IIS Aragón, Institute of Health Carlos III and REDISSEC, Zaragoza, Spain
| | | | - Maria João Forjaz
- 2National School of Public Health, Institute of Health Carlos III and REDISSEC, Avda. Monforte de Lemos 5, 28029 Madrid, Spain
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Wijers IGM, Ayala A, Rodriguez-Blazquez C, Rodriguez-Laso A, Rodriguez-Rodriguez V, Forjaz MJ. Rasch Analysis and Construct Validity of the Disease Burden Morbidity Assessment in Older Adults. Gerontologist 2018; 58:e302-e310. [PMID: 30219906 DOI: 10.1093/geront/gnx061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Indexed: 11/12/2022] Open
Abstract
Purpose of the Study The Disease Burden Morbidity Assessment (DBMA) is a self-report questionnaire in which participants rate the disease burden caused by a number of medical conditions. This paper studies the measurement properties of the DBMA, using Rasch analysis. Design and Methods We used data of 1,400 community-dwelling adults aged 50 years and older participating in the Ageing in Spain Longitudinal Study, Pilot Survey (ELES-PS). Test of fit to the Rasch model, reliability, unidimensionality, response dependency, category structure, scale targeting, and differential item functioning (DIF) were studied in an iterative way. Construct validity of the linear measure provided by the Rasch analysis was subsequently assessed. Results To achieve an adequate fit to the Rasch model, all items were rescored by collapsing response categories. Reliability (Person Separation Index) was low. The scale was unidimensional and neither response dependency nor relevant DIF were found. The linear measure had a correlation of -0.48 with physical functioning, -0.47 with perceived health, 0.32 with depression, and -0.24 with quality of life (QoL) and displayed satisfactory known-groups validity by sex and age groups. Relative precision analysis showed that the linear measure discriminated better between age groups than the original raw score, but for sex no difference was found. Implications Despite some limitations, support was found for the validity of the DBMA in older adults. Its linear scores may be useful to assess strategies aimed at improving the QoL of patients with multimorbidity. More research is needed in a hospital-based sample.
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Affiliation(s)
- Irene G M Wijers
- Department of Preventive Medicine and Quality Management, General University Hospital Gregorio Marañón, Madrid, Spain
| | - Alba Ayala
- National School of Public Health, Carlos III Institute of Health and REDISSEC, Madrid, Spain
| | | | - Angel Rodriguez-Laso
- Biomedical Research Foundation of the University Hospital of Getafe, Madrid, Spain
| | | | - Maria João Forjaz
- National School of Public Health, Carlos III Institute of Health and REDISSEC, Madrid, Spain
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Kurtis MM, Balestrino R, Rodriguez-Blazquez C, Forjaz MJ, Martinez-Martin P. A Review of Scales to Evaluate Sleep Disturbances in Movement Disorders. Front Neurol 2018; 9:369. [PMID: 29896152 PMCID: PMC5986889 DOI: 10.3389/fneur.2018.00369] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/07/2018] [Indexed: 01/09/2023] Open
Abstract
Patients with movement disorders have a high prevalence of sleep disturbances that can be classified as (1) nocturnal sleep symptoms, such as insomnia, nocturia, restless legs syndrome (RLS), periodic limb movements (PLM), obstructive sleep apnea (OSA), and REM sleep behavior disorder; and (2) diurnal problems that include excessive daytime sleepiness (EDS) and sleep attacks. The objective of this review is to provide a practical overview of the most relevant scales that assess these disturbances to guide the choice of the most useful instrument/s depending on the line of research or clinical focus. For each scale, the reader will find a brief description of practicalities and psychometric properties, use in movement disorder cohorts and analyzed strengths and limitations. To assess insomnia, the Pittsburgh Sleep Quality Index, a generic scale, and three disease-specific scales: the Parkinson Disease Sleep Scale (PDSS), the PDSS-2, and Scales for outcomes in Parkinson's disease (PD)-Sleep-Nocturnal Sleep subscale are discussed. To evaluate nocturia, there are no specific tools, but some extensively validated generic urinary symptom scales (the Overall Bladder Questionnaire and the Overactive Bladder Symptom Score) and some PD-specific scales that include a nocturia item are available. To measure RLS severity, there are currently four domain-specific generic scales: The International Restless Legs Scale, the Johns Hopkins Restless Legs Severity Scale, the Restless Legs Syndrome-6 measure, a Pediatric RLS Severity Scale, and the Augmentation Severity Rating Scale (a scale to evaluate augmentation under treatment) and several instruments that assess impact on quality of sleep and health-related quality of life. To evaluate the presence of PLM, no clinical scales have been developed to date. As far as OSA, commonly used instruments such as the Sleep Apnea Scale of the Sleep Disorders Questionnaire, the STOP-Bang questionnaire, and the Berlin Questionnaire are reviewed. Three scales have been extensively used to assess EDS: the generic Epworth Sleepiness Scale, the Stanford Sleepiness Scale, and the PD-specific Scales for outcomes in PD-Sleep-Daytime sleepiness subscale. To date, only the Inappropriate Sleep Composite Score specifically evaluates propensity to sleep attacks.
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Affiliation(s)
- Mónica M. Kurtis
- Movement Disorders Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain
| | - Roberta Balestrino
- Department of Neuroscience Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Institute of Health Carlos III, Madrid, Spain
| | - Maria João Forjaz
- National School of Public Health and Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Institute of Health Carlos III, Madrid, Spain
| | - Pablo Martinez-Martin
- National Center of Epidemiology and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Institute of Health Carlos III, Madrid, Spain
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Martinez-Martin P, Rodriguez-Blazquez C, Catalan MJ. Independent and Complementary Validation of the QUIP-RS in Advanced Parkinson's Disease. Mov Disord Clin Pract 2018; 5:341-342. [PMID: 30800709 DOI: 10.1002/mdc3.12603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 02/01/2018] [Accepted: 02/08/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED Carlos III Institute of Health Madrid Spain
| | | | - Maria Jose Catalan
- Hospital Clínico San Carlos, Movement Disorders Unit, Department of Neurology Madrid Spain
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Martinez-Martin P, Rodriguez-Blazquez C, Forjaz MJ, Kurtis MM, Skorvanek M. Measurement of Nonmotor Symptoms in Clinical Practice. Int Rev Neurobiol 2017; 133:291-345. [PMID: 28802923 DOI: 10.1016/bs.irn.2017.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Nonmotor symptoms constitute a prominent part of Parkinson's disease manifestations. They are present since the first phases of the disease, increase their number and severity with disease progression, and importantly impact on patients' health and quality of life, caregivers' burden, and social resources. Research on Parkinson's disease has traditionally focused on the motor aspects of the disease, but an increasing interest in the nonmotor manifestations has risen in the past decade. The availability of assessment instruments for detecting and measuring these symptoms has allowed understanding of their importance and course over time, as well as estimation of therapeutic effects on them. In this chapter, a review of the basic characteristics of nonmotor symptom assessments used in clinical practice and research are presented.
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Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Institute of Health Carlos III, Madrid, Spain.
| | | | - Maria João Forjaz
- National School of Public Health and REDISSEC, Institute of Health Carlos III, Madrid, Spain
| | - Monica M Kurtis
- Movement Disorders Unit, Hospital Ruber Internacional, Madrid, Spain
| | - Matej Skorvanek
- P.J. Safarik University, Kosice, Slovakia; University Hospital of L. Pasteur, Kosice, Slovakia
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Skorvanek M, Martinez-Martin P, Kovacs N, Rodriguez-Violante M, Corvol JC, Taba P, Seppi K, Levin O, Schrag A, Foltynie T, Alvarez-Sanchez M, Arakaki T, Aschermann Z, Aviles-Olmos I, 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, Huang J, 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, Tilley BC, Valkovic P, Goetz CG, Stebbins GT. Differences in MDS-UPDRS Scores Based on Hoehn and Yahr Stage and Disease Duration. Mov Disord Clin Pract 2017; 4:536-544. [PMID: 30363418 DOI: 10.1002/mdc3.12476] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 12/06/2016] [Accepted: 12/10/2016] [Indexed: 12/25/2022] Open
Abstract
Background The Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is a newly developed tool to assess Parkinson's disease (PD). Changes in scores on the scale over the course of PD, including increasing disease duration and Hoehn and Yahr (HY) stages, have not been described. The objectives of this study were to analyze MDS-UPDRS scores on Parts I through IV and their differences based on HY stage and disease duration in a large cohort of patients with PD. Methods For this cross-sectional study, demographic data and MDS-UPDRS scores were collected, including HY stage. Subscores on MDS-UPDRS Parts I through IV were analyzed using 1-way analyses of variance for each HY stage and in 5-year increments of disease duration. Part III (motor assessment) scores were analyzed separately for on and off states. Results The mean age of the 3206 patients was 65.8 ± 10.6 years, 53.3% were men, the mean disease duration was 11.5 ± 4.6 years, and the median HY stage was 2 (range, 0-5); 2156 patients were examined in an on state and 987 were examined in an off state. Scores for all MDS-UPDRS parts increased significantly through HY stages 1 through 5, with an average increase of 3.8, 7.7, 14.6, and 2.0 points consecutively for parts I through IV, respectively. For the 5-year increments of disease duration, MDS-UPDRS subscores increased by an average of 1.6, 3.3, 4.2, and 1.4 points consecutively for parts I through IV, respectively. This increase was significant only during the first 15 years of disease for all 4 parts, including part III scores evaluated in both on and off states. Conclusions MDS-UPDRS scores for all 4 parts increase significantly with every HY stage and also with 5-year increments of disease duration in the first 15 years of the disease.
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Wijers IGM, Ayala A, Rodriguez-Blazquez C, Rodriguez-Laso A, Rodriguez-Rodriguez V, Forjaz MJ. Disease burden morbidity assessment by self-report: Psychometric properties in older adults in Spain. Geriatr Gerontol Int 2016; 17:1102-1108. [PMID: 27426678 DOI: 10.1111/ggi.12835] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/09/2016] [Accepted: 04/26/2016] [Indexed: 11/30/2022]
Abstract
AIM To carry out an analysis of the psychometric properties of the Disease Burden Morbidity Assessment (DBMA) according to the assumptions of the Classical Test Theory. METHODS A sample of 707 community-dwelling adults aged 65 years and older, living in Spain, completed the DBMA. Psychometric properties of the scale (feasibility, acceptability, scaling assumptions, reliability and construct validity) were analyzed. RESULTS The mean DBMA score was 6.8. Feasibility and acceptability were satisfactory, except for large floor effects (>50%), as well as a skewed distribution (1.8). Item-total corrected correlation ranged 0.10-0.49, item homogeneity index was 0.09 and Cronbach's alpha was 0.72. Disease burden correlated strongly with physical functioning (r = -0.56) and perceived health (r = -0.56), and moderately with depression (r = 0.41) and the Personal Wellbeing Index (r = -0.41). Exploratory factor analysis extracted five factors, explaining 44% of the variance. CONCLUSIONS The DBMA is an acceptable and valid instrument for measuring disease burden in older adults. Future studies should include Rasch analysis to further assess dimensionality and explore other measurement properties. Geriatr Gerontol 2017; 17: 1102-1108.
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Affiliation(s)
- Irene G M Wijers
- Department of Preventive Medicine and Quality Management, General University Hospital Gregorio Marañón, Madrid, Spain
| | - Alba Ayala
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Madrid, Spain
| | | | - Angel Rodriguez-Laso
- Department of Pharmacology and Biotechnology, Universidad Europea, Madrid, Spain
| | | | - Maria João Forjaz
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Madrid, Spain
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van der Heeden JF, Marinus J, Martinez-Martin P, Rodriguez-Blazquez C, Geraedts VJ, van Hilten JJ. Postural instability and gait are associated with severity and prognosis of Parkinson disease. Neurology 2016; 86:2243-50. [PMID: 27178702 DOI: 10.1212/wnl.0000000000002768] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/17/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Differences in disease progression in Parkinson disease (PD) have variously been attributed to 2 motor subtypes: tremor-dominant (TD) and postural instability and gait difficulty (PIGD)-dominant (PG). We evaluated the role of these phenotypic variants in severity and progression of nondopaminergic manifestations of PD and motor complications. METHODS Linear mixed models were applied to data from the Profiling Parkinson's disease (PROPARK) cohort (n = 396) to evaluate the effect of motor subtype on severity and progression of cognitive impairment (Scales for Outcomes in Parkinson's disease [SCOPA]-Cognition [SCOPA-COG]), depression (Hospital Anxiety and Depression Scale [HADS]), autonomic dysfunction (SCOPA-Autonomic [SCOPA-AUT]), excessive daytime sleepiness, psychotic symptoms (SCOPA-Psychiatric Complications [SCOPA-PC]), and motor complications. In first analyses, subtype as determined by the commonly used ratio of tremor over PIGD score was entered as a factor, whereas in second analyses separate tremor and PIGD scores were used. Results were verified in an independent cohort (Estudio Longitudinal de Pacientes con Enfermedad de Parkinson [ELEP]; n = 365). RESULTS The first analyses showed that PG subtype patients had worse SCOPA-COG, HADS, SCOPA-AUT, SCOPA-PC, and motor complications scores, and exhibited faster progression on the SCOPA-COG. The second analyses showed that only higher PIGD scores were associated with worse scores for these variables; tremor score was not associated with severity or progression of any symptom. Analyses in the independent cohort yielded similar results. CONCLUSIONS In contrast to PIGD, which consistently was associated with greater severity of nondopaminergic symptoms, there was no evidence of a benign effect of tremor. Our findings do not support the use of the TD subtype as a prognostic trait in PD. The results showed that severity of PIGD is a useful indicator of severity and prognosis in PD by itself.
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Affiliation(s)
- Jorine F van der Heeden
- From the Department of Neurology (J.F.v.d.H., J.M., V.J.G., J.J.v.H.), Leiden University Medical Center, the Netherlands; and National Centre for Epidemiology and CIBERNED (P.M.-M., C.R.-B.), Carlos III Institute of Health, Madrid, Spain.
| | - Johan Marinus
- From the Department of Neurology (J.F.v.d.H., J.M., V.J.G., J.J.v.H.), Leiden University Medical Center, the Netherlands; and National Centre for Epidemiology and CIBERNED (P.M.-M., C.R.-B.), Carlos III Institute of Health, Madrid, Spain
| | - Pablo Martinez-Martin
- From the Department of Neurology (J.F.v.d.H., J.M., V.J.G., J.J.v.H.), Leiden University Medical Center, the Netherlands; and National Centre for Epidemiology and CIBERNED (P.M.-M., C.R.-B.), Carlos III Institute of Health, Madrid, Spain
| | - Carmen Rodriguez-Blazquez
- From the Department of Neurology (J.F.v.d.H., J.M., V.J.G., J.J.v.H.), Leiden University Medical Center, the Netherlands; and National Centre for Epidemiology and CIBERNED (P.M.-M., C.R.-B.), Carlos III Institute of Health, Madrid, Spain
| | - Victor J Geraedts
- From the Department of Neurology (J.F.v.d.H., J.M., V.J.G., J.J.v.H.), Leiden University Medical Center, the Netherlands; and National Centre for Epidemiology and CIBERNED (P.M.-M., C.R.-B.), Carlos III Institute of Health, Madrid, Spain
| | - Jacobus J van Hilten
- From the Department of Neurology (J.F.v.d.H., J.M., V.J.G., J.J.v.H.), Leiden University Medical Center, the Netherlands; and National Centre for Epidemiology and CIBERNED (P.M.-M., C.R.-B.), Carlos III Institute of Health, Madrid, Spain
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