Measuring fatigue in patients with Parkinson's disease – the Fatigue Severity Scale

Abstract

The objective was to compare the prevalence and severity of fatigue in patients with Parkinson's disease (PD) with that in two control groups, one consisting of randomly chosen control subjects of the same age and sex distribution and the other consisting of patients with coxarthrosis waiting to receive total hip replacement. We also explored the possible correlation of demographic and clinical data to the presence and severity of fatigue. Sixty-six patients with PD, 131 randomly chosen controls and 79 patients with coxarthrosis, waiting to receive total hip replacement, were evaluated for fatigue. Patients and controls with a depressive mood disorder or cognitive impairment had been excluded from the study. Fatigue was measured by the Fatigue Severity Scale (FSS). For the patients with PD the mean total FSS score was 4.1, compared with 2.7 amongst the randomly chosen control group and 2.9 in the group consisting of patients with coxarthrosis. Fifty per cent of the patients with PD had a mean total FSS score of 4 or higher, compared with 25% in both of the two control groups. There was no correlation between pain, presence of self-reported nocturnal sleep disorders or duration of PD and fatigue. The patients with fatigue did have a more advanced disease, measured both by Unified Parkinson's Disease Rating Scale score and Hoehn and Yahr stage. Although the univariate analyses indicated that more severe parkinsonism was correlated to the symptom, the multivariate analysis showed that none of the studied variables were significant explanatory factors for fatigue. Fatigue is a common symptom in patients with PD without depression or dementia. The study indicates that fatigue is an independent symptom of the disease without relation to other motor or non-motor symptoms.

Fatigue in persons who have lived with spinal cord injury for >20 years

“…As the number of variables used in the linear regression model is limited by the size of the studied population, we merged health problems further into three categories. The participants were asked for details about their daily medication, and their responses were merged into the following groups: (1) no daily medication at all; (2) medication that never or seldom causes fatigue as a side effect; (3) medication that often or always causes fatigue as a side effect; (4) medication with two or more drugs that often or always causes fatigue as a side effect. Medication side effects were identified by referencing the Norwegian formulary on pharmaceuticals ('Felleskatalogen') and then classified as either 'never' or 'seldom' causing fatigue or 'often' or 'always' causing fatigue in cases where reported side effects included fatigue, somnolence, drowsiness, weakness, sedation or asthenia.…”

“…1 Commonly distinguished according to mental and physical forms, fatigue is oftentimes a disabling symptom found in a variety of medical and neurologic disorders. 2,3 Recent decades has seen life-expectancy improvements for persons who sustain a traumatic spinal cord injury (SCI).…”

Medication use is associated with fatigue in a sample of community-living individuals who have a spinal cord injury: a chart review

“…1 Studies of individuals with SCI [2][3][4] have identified fatigue as a problem and recently, we reported that the prevalence of fatigue severe enough to interfere with function was 57% in a sample of outpatients with SCI. 5 Rehabilitation practitioners are limited in their ability to address fatigue because there is insufficient research on the diagnosis and treatment of fatigue in SCI and therefore, evidence-based approaches are lacking.…”

Measuring Fatigue in Parkinson's Disease: A Psychometric Study of Two Brief Generic Fatigue Questionnaires

“…This can pose a challenge to measurement. In Parkinson's disease (PD), fatigue has been reported in 40-65% of patients and although many consider it to be one of their most disabling symptoms, it often remains undetected in clinical practice (4)(5)(6)(7)(8). Its cause remains unclear.…”

“…Studies have tended to use fatigue scales from generic health status questionnaires or approaches not validated in PD (4)(5)(6)(7)(8)(10)(11)(12). Although generic health status questionnaires have been validated broadly, their subscales are brief and often lack sufficient detail for accurately measuring individuals.…”