Is quality of life in non‐demented Parkinson’s disease patients related to cognitive performance? A clinic‐based cross‐sectional study

Abstract

Whilst the association between dementia and poorer health-related quality of life (Hr-QoL) in Parkinson's disease (PD) has been well established, we aimed to explore the relationship between cognitive performance and Hr-QoL in PD without dementia. Consecutive PD patients (n = 124, 54% men, age 60.4 +/- 10.3 years) judged as non-demented based on DSM-IV criteria and Mini Mental State Examination, free of other neurodegenerative diseases or psychotic difficulties and antipsychotic/antidepressive/anxyolitic treatment were assessed in a battery of neuropsychological tests. We used Parkinson's disease questionnaire (PDQ-39) to asses Hr-QoL and Beck's Depression Inventory (BDI) to quantify depression. In the univariate analysis, better performance in each of the tests evaluating visual attention/memory or visuospatial and executive functions was associated with better Hr-QoL. In multivariate analysis [adjustment for BDI score, PD severity and duration, l-dopa dose, age, sex, education, employment status and early PD onset (<50 years of age)] in which these tests were either represented by a common variable identified in a principal components analysis or were considered individually, better cognitive performance was independently associated with better Hr-QoL. The association was conditional on the level of depression, i.e., apparent only in patients with low(er) BDI scores. Cognitive performance appears associated with Hr-QoL even in non-demented PD patients.

Cognitive predictors of balance in Parkinson’s disease

“…Examples include inhibition of automated responses, recovery from declarative memory, planning, monitoring, cognitive flexibility, and the maintenance of information in the working memory (Schwarz and Shapiro 1986). Cognitive impairments can have a significant negative influence on carrying out daily life activities and are associated with a lower quality of life (Klepac et al 2008). …”

Quality of Life in Patients with Neurodegenerative Diseases

“…Several predictors of physical and mental components were found [1]. Associations with visual attention/memory functions, visuospatial and executive have been established and cognitive domains are apparently related to life' quality [7].…”

“…We found limitations in the analyzed articles: not representative sample of the population [1], the relevance of self-report (which can condition the individual and clinical characteristics) [1,4,6], the cross-sectional design of the study [1,6], the use of non-specific resources for pathologies [6], the data generalization to clinical observations [7].…”

“…The presents studies evaluated the association of HRQoL in patients with Parkinson's and Multiple Sclerosis disease, such as, depressive symptoms (high level of depression) and also (although less prominent and/or less consistently) deficiencies, high motor difficulties, longer disease and risk behaviors (smoking, alcohol) [5][6][7].…”

“…It was also objective of the study, validate these two instruments and their relationship to quality of life through the analysis of Hospital Anxiety and Depression Scale -Depression (HADS-D), Fatigue Assessment Scale (FAS) and Satisfaction With Life (SWL), Multiple Sclerosis Impact Scale (MSIS-29), Parkinson's Disease Questionnaire (PDQ-39) [5,7].…”