Influence of clinical and demographic variables on quality of life in patients with Parkinson's disease

Abstract

Objectives-To identify the clinical and demographic factors that are associated with a poor quality of life in patients with Parkinson's disease. Methods-233 of a total of 245 patients identified in a community based study in a Norwegian county participated in the study. Quality of life was measured by the Nottingham Health Profile (NHP). The results were compared with those in 100 healthy elderly people. Clinical and demographic variables were determined during a semistructured interview and by clinical examination by a neurologist. Multiple regression analyses were used to determine which variables were associated with higher distress scores. Results-Patients with Parkinson's disease had higher distress scores than the healthy elderly people for all the NHP dimensions. The variables that most strongly predicted a high total NHP score were depressive symptoms, self reported insomnia, and a low degree of independence, measured by the Schwab and England scale. Severity of parkinsonism contributed, but to a lesser extent. Nearly half the patients with Parkinson's disease reported lack of energy, compared with a fifth of the control group. Severity of depressive symptoms and a higher score on the UPDRS motor subscale only partly accounted for this finding. Only 30% of the variation in NHP energy score was explained by the predictive variables identified in this study. Conclusions-Parkinson's disease has a substantial impact on health related quality of life. Depressive symptoms and sleep disorders correlated strongly with high distress scores. Patients with Parkinson's disease should be examined for both conditions, which require treatment. Low energy was commonly reported and may be a separate entity of Parkinson's disease. (J Neurol Neurosurg Psychiatry 1999;66:431-435) Keywords: Parkinson's disease; quality of life; multiple regression analysis Medical treatment and management of patients with Parkinson's disease has concentrated on preserving normal life expectancy and limiting motor disabilities. The disease, however, also aVects patients' health related quality of life in many other ways.

Effects of Sleep Disorders on the Non-Motor Symptoms of Parkinson Disease

“…[26][27][28][29] Additionally, sleep disorders have been shown to substantially impact healthrelated quality of life in patients with PD. 30 Few studies have assessed possible relationships between any given sleep disorder and different NMS in PD population. Those studies that did question this relationship primarily assessed RBD, which has been demonstrated to be associated with hallucinations, [31][32][33] cognitive impairment, 34,35 psychiatric comorbidity, 36 increased falls, 36,37 poor emotional functioning, and lower quality of life.…”

Avaliação das atividades da vida diária dos pacientes com doença de Parkinson submetidos a cirurgia estereotáxica

“…Nos últimos anos, a qualidade de vida dos pacientes com DP tem sido considerada de grande importância, e novos estudos e escalas surgiram para melhor análise 24,[34][35][36] . As escalas mais frequentemente utilizadas são a PDQ -39 (Parkinson's Disease Questionaire) e a SF -36 37 .…”

Depression in Parkinson’s disease: Health risks, etiology, and treatment options

“…However, there is also a growing literature that shows that even beyond motor disability, depression can be a risk factor for reduced HRQL in PD (Karlsen et al 1995;Hobson et al 1999;. Karlsen et al (1999) used the Nottingham Health Profi le (NHP) to determine which clinical features reduce HRQL in PD. A generic quality of life questionnaire, the NHP, measures six dimensions -emotional reactions, energy, pain, physical mobility, sleep, and social isolation (Jenkinson et al 1988).…”