Parkinson's disease: Impact of clinical and cognitive aspects on quality of life

Abstract

Parkinson’s disease (PD) is a chronic disease manifested principally by motor signs and symptoms, but with frequent neuropsychological alterations.ObjectivesTo study the relationship between clinical and cognitive aspects and the perception of quality of life (QOL) in PD patients.MethodsTwenty consecutive patients (13 men) with idiopathic PD (mean age: 64.5y), mean disease time of 7.8 years and at stages 1-3 according to the modified Hoehn and Yahr staging scale (HYS), all outpatients from the Neurology Department of the Celso Pierro General and Maternity Hospital (PUC-Campinas), were analyzed. The following were applied: a clinical-neurological assessment, the Mini-Mental State Examination (MMSE), standard neuropsychological battery of the CERAD (Consortium to Establish a Registry for Alzheimer’s Disease), Hamilton Depression Rating Scale (HAM-D) and a QOL questionnaire (Parkinson’s Disease Questionnaire - PDQ-39). Statistical analysis was carried out at a significance level of p<0.05.ResultsOn the PDQ-39 under the sections total, mobility and activities of daily living, and the items motor compromise (HYS) and language of the MMSE were predictors of worse QOL. Verbal fluency was a factor for emotional well-being on the PDQ-39, whereas higher scores for HAM-D and worse performance on the item attention and calculation of the MMSE were associated with worse QOL in the social support section. Total score on the MMSE and educational level were QOL factors in cognition.ConclusionsThe findings of the present study suggest that clinical, cognitive, motor or other depression-related factors contribute differently to the domains of QOL.

Quality of life in Parkinson’s disease patients: progression markers of mild to moderate stages

“…On the other hand, this finding may be explained by the fact that a chronic disease that causes increasing dependence can be a source of conflict and strengthen or weaken affective ties and family bonds 14,27 . While in the present study older age among individuals in the moderate stage was related to worse scores for ADLs and cognition in the PDQ-39, in a study by Tedrus et al, 28 the greatest impairment was observed for the ADL and mobility domains. Longer disease duration was associated with greater impairment of quality of life in the ADL and emotional well-being domains in the PDQ-39, a finding also reported in other studies 26,29 .…”

“…Longer disease duration was associated with greater impairment of quality of life in the ADL and emotional well-being domains in the PDQ-39, a finding also reported in other studies 26,29 . In the study by Tedrus et al, 28 a decline in quality of life in individuals with PD was associated not only with disease duration but also with advanced age and age of onset.…”

Qualidade de vida e o estágio de comprometimento em sujeitos com doença de Parkinson

“…Observamos nesse estudo, uma alta correlação entre o total da PDQL e os seus domínios, assim como em muitos outros estudos 18,27,28 que fizeram a correlação entre a pontuação total e de seus domínios.…”

Individualized guidance and telephone monitoring in a self-supervised home-based physiotherapeutic program in Parkinson

“…These can imply loss of autonomy and independence of the individual, negatively influencing their quality of life (QoL) (3)(4)(5).…”