Determinants of Quality of Life According to Cognitive Status in Parkinson’s Disease

Abstract

Background: Quality of life (QoL) was worse in Parkinson's disease patients with mild cognitive impairment (PD-MCI) or dementia (PDD) than PD patients with normal cognition (PD-NC). The aim of this study was to investigate and compare the potential heterogeneous determinants of QoL in PD patients with different cognitive statuses. Methods: We recruited 600 PD patients, including 185 PD-NC patients, 336 PD-MCI patients and 79 PDD patients, in this cross-sectional study. All patients completed the QoL assessment by the 39-item Parkinson's Disease Questionnaire (PDQ-39), as well as clinical evaluations and neuropsychological tests. The determinants of the QoL were analyzed by multiple stepwise regression analysis. Results: QoL was more impaired across the three groups (PD-NC < PD-MCI < PDD). The Unified Parkinson's Disease Rating Scale part III (UPDRS-III) score, Geriatric Depression Rating Scale (GDS) score and daily levodopa equivalent dose (LED) were independent variables of PDQ-39 in PD-NC patients. The GDS score, disease duration, UPDRS-III score, Epworth Sleepiness Score (ESS) and sex were independent variables of PDQ-39 in PD-MCI patients. The GDS score and disease duration were independent variables of PDQ-39 in PDD patients. Conclusion: The determinants of QoL in PD-NC, PD-MCI and PDD patients were heterogeneous. Motor function was considered to be the most crucial determinant for QoL in PD-NC, while depression was indicated to be the most vital determinant for PD-MCI and PDD. For QoL improvement, clinicians might need to focus more on motor function in PD-NC patients and on depression in PD-MCI and PDD patients.

Disease progression in Parkinson‘s disease patients with subjective cognitive complaint

“…The Epworth Sleepiness Scale (ESS) 18 was used to evaluate excessive daytime sleepiness. The Mini Mental State Examination (MMSE) 19 was performed to assess global cognitive function, and a full set of neuropsychological tests for five specific cognitive domains were performed as previously described 20,21 . The routinely used Parkinson's Disease Questionnaire (PDQ‐39) was conducted to determine QoL and included eight subscales 22 …”

“…The Mini Mental State Examination (MMSE) 19 was performed to assess global cognitive function, and a full set of neuropsychological tests for five specific cognitive domains were performed as previously described. 20,21 The routinely used Parkinson's Disease Questionnaire (PDQ-39) was conducted to determine QoL and included eight subscales. 22 Cognitive classifications SCC was diagnosed if there was no evidence of cognitive impairment on standard tests and the patient's answer to the following single question is "yes" as previously recommended: "Over the past week have you had problems remembering things, following conversations, paying attention, thinking clearly, or finding your way around the house or in town?".…”

Quality of Life and its Predictors Among Neurosurgical Patients — Systematic Review of Research

“…The performed Spearman's correlation analysis showed the following influence of certain factors on HRQOL: disease duration (R = 0.30, p < 0.001), tremor dominant (R = -0.17, p = 0.006), MMSE (R = -0.25, p = 0.0001), cognitive impairment (R = 0.38, p < 0.0001), depressed mood (R = 0.35, p < 0.0001), anxious mood (R = 0.29, p < 0.0001), apathy (R = 0.33, p < 0.0001), night-time sleep problems (R = 0.29, p < 0.0001), daytime sleepiness (R = 0.35, p < 0.0001), pain and other sensations (R = 0.38, p < 0.0001), urinary problems (R = 0.30, p < 0.0001), constipation problems (R = 0.13, p = 0.0281). In addition, Fan et al [15] also assessed the determinants of quality of life in patients with PD. It was shown that the most severe determinant of the QOL was The Epworth Sleepiness Scale (R² = 0.02, β = 0.44, p = 0.0099), GDS score (R² = 0.35, β = 1.05, p < 0.0001), female (R² = 0.01, β = 3.38, p = 0.0257) and disease duration (R² = 0.04, β = 0.83, p = 0.0116).…”

Baduanjin Qigong Intervention by Telerehabilitation (TeleParkinson): A Proof-of-Concept Study in Parkinson’s Disease

“…Among the motor symptoms, resting tremor, rigidity, postural instability, slowness of movement, and freezing while walking are particularly disabling [ 2 ] and, because pharmacological treatments cannot fully compensate or relieve them, greater issues arise. Recurrent falls (~39%, ~20 falls per year) [ 3 ]; frequent rehospitalizations to acute care (patients with a history of hospitalization are 1.7 times more likely to undergo re-hospitalization compared to those without a prior event) [ 4 ]; and admission to long-term care facilities (5–10% prevalence of PD among all patients) [ 5 ], depression, and cognitive impairment, among others, have been reported to significantly impact the quality of life of patients with PD [ 6 ] and, ultimately, to increase their likelihood of developing other comorbidities and dying prematurely [ 7 ].…”