Assessment of fatigue in Parkinson′s disease: Indian perspective

Abstract

Context:Fatigue is one of the most frequent nonmotor manifestations in Parkinson's disease (PD), having a major effect on quality of life but is not reported in Indian patients.Aims:To evaluate the frequency of fatigue in a cohort of PD population and its correlation with disease.Settings and Design:Fatigue Severity Scale (FSS) was translated and validated in local vernacular language. All patients of PD visiting neurology outpatient department of a tertiary care hospital.Subjects and Methods:A total of 150 patients were screened, and 104 were included in this study. They were divided into – Group I with fatigue (score of >4 in each item) and Group II without fatigue.Statistical Analysis:Data were analyzed by SPSS software version 20.0. Spearman correlation was used to evaluate the convergent validity of the FSS-Ind score with PD-related variables. The principal components analysis was applied to detect the domain structure of the FSS.Results:Of the total 104 patients, 68 (65.3%) patients experienced fatigue. The duration of disease was significantly more (P = 0.021) in Group I (4.39 ± 3.8 years) than in the Group II (3.13 ± 1.6 years). The severity of disease also showed a positive correlation with fatigue with 50.9% patients in H and Y stage >3 experiencing fatigue. 69.1% patients of tremor phenotype experienced fatigue as compared to 32.3% of rigid phenotype. There was no relation of fatigue with age, gender, H and Y stage, levodopa equivalent dose and mean Unified PD Rating Scale motor III score.Conclusions:Translated version of the FSS, FSS-Ind has high internal consistency and validity which supports its application as an effective tool in detecting fatigue in patients with PD. Fatigue in PD was related to duration and phenotype of the disease.

Fatigue in Parkinson's disease: A systematic review and meta‐analysis

“…The relation between fatigue and age was reported in 24 studies, two of which found an association between fatigue and higher age. The meta‐analysis for age showed that patients with fatigue were, on average, 1.4 years older than those without fatigue (for the forest plot, see Supplementary Material 5).…”

“…Male sex was less associated with fatigue in one of 22 cohorts in which this issue was explored. The meta‐analysis did not find an association between fatigue and sex (Supplementary Material 6).…”

“…Fatigue was associated with longer disease durationin seven of 22 cohorts in which this issue was explored.…”

“…Demographic features, disease severity, cognitive impairment, and depression did not exert significant effects on prevalence estimates. Following Barone and colleagues, we contrasted studies on de novo (five of 44 studies) versus studies on treated PD patients in which the same scale was used (28 studies). This contrast did not show differences in fatigue prevalence between treated and de novo PD patients (Table ).…”

“…One study of 14 reported an association between fatigue and higher LEDD. The meta‐analysis showed that patients with fatigue had, on average, 50.89 more units of LEDD than those without fatigue (Supplementary Material 8).…”