Motor and non-motor function predictors of mortality in Parkinson’s disease

Bugalho, Paulo; Ladeira, Filipa; Barbosa, Raquel; Marto, João Pedro; Borbinha, Cláudia; Salavisa, Manuel; Conceição, Laurete da; Saraiva, Marlene; Fernandes, Marco; Meira, Bruna

doi:10.1007/s00702-019-02055-3

Cited by 28 publications

(27 citation statements)

References 29 publications

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“…NMSs in PD involve a multitude of functions, including disorders of sleep-wake cycle regulation, disorders of mood and affect, autonomic dysfunction, sensory symptoms, pain, and cognitive impairment [ 2 ]. Several studies have suggested that the impact of NMS on disability and health-related quality of life is higher than that of motor dysfunction, but less is known about the possible influence of NMS on mortality [ 3 ].…”

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confidence: 99%

Increased Mortality in Young-Onset Parkinson’s Disease

Hustad¹,

Myklebust

Gulati

et al. 2021

JMD

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Objective Few studies have followed Parkinson’s disease (PD) patients from the time of diagnosis to the date of death. This study compared mortality in the Trondheim PD cohort to the general population, investigated causes of death and analyzed the associations between mortality and age at disease onset (AAO) and cognitive decline defined as Montreal Cognitive Assessment (MoCA) score below 26.Methods The cohort was followed longitudinally from 1997. By the end of January 2020, 587 patients had died. Comparisons to the Norwegian population were performed by calculating standardized mortality ratios (SMRs). Survival curves were estimated using the standard Kaplan-Meier estimator, and multivariable Cox proportional hazard models were estimated to investigate associations.Results SMR was 2.28 [95% confidence interval (CI): 2.13–2.44] for the whole cohort. For participants with AAO 20–39 years, the SMR was 5.55 (95% CI: 3.38–8.61). Median survival was 15 years (95% CI: 14.2–15.5) for the whole cohort. Early-onset PD (EOPD) patients (AAO < 50 years) had the longest median survival time. For all groups, there was a significant shortening in median survival time and an almost 3-fold higher age- and sex-adjusted hazard ratio for death when the MoCA score decreased below 26.Conclusion PD patients with an AAO before 40 years had a more than fivefold higher mortality rate compared to a similar general population. EOPD patients had the longest median survival; however, their life expectancy was reduced to a greater degree than that of late-onset PD patients. Cognitive impairment was strongly associated with mortality in PD.

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confidence: 99%

Increased Mortality in Young-Onset Parkinson’s Disease

Hustad¹,

Myklebust

Gulati

et al. 2021

JMD

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“…NMS are frequent, may precede the onset of motor symptoms, correlate variably with the severity of the motor impairment, and become increasingly prevalent with advancing disease 1,5,6 . NMS in PD cause a significant disease burden and quality of life deterioration 7,8 and are a predictor of mortality 9 …”

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Prevalence of Non‐Motor Symptoms and Non‐Motor Fluctuations in Parkinson's Disease Using the MDS‐NMS

Rodríguez‐Blázquez

Schrag

Rizos

et al. 2020

Movement Disord Clin Pract

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Background Non‐motor symptoms (NMS) are frequent in Parkinson's disease (PD). Objectives To estimate the prevalence of NMS and of non‐motor fluctuations (NMF) using the Movement Disorders Society‐Non‐Motor Rating Scale (MDS‐NMS) and other scales assessing NMS, and their relationship with sex and PD severity. Methods Cross‐sectional study with a sample of 402 PD patients. The Hoehn and Yahr staging system (HY), Clinical Impression of Severity Index for PD (CISI‐PD), MDS‐NMS (including NMF‐ subscale), Non‐Motor Symptoms scale (NMSS), and MDS‐Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) were applied. A NMS was considered present when scored ≥1. Differences in scores by sex and HY, CISI‐PD, and MDS‐UPDRS severity levels were calculated using Fisher's exact and chi‐squared tests. Results Using the MDS‐NMS, NMS were present in 99.7% of patients and the mean number of NMS was 16.13 (SD: 9.36). The most prevalent NMS was muscle, joint or back pain (67.4% of the sample) and the least prevalent was dopamine dysregulation syndrome (2.2%). Feeling sad or depressed was significantly more prevalent in women. Using the MDS‐NMS revealed more NMS than the other scales assessing NMS. NMF were present in 41% of the sample, with fatigue being the most prevalent symptom (68.5% patients with NMF), and no differences by sex. Patients with greater PD severity had higher prevalence of NMS than patients with lower severity. Conclusions Almost all patients with PD experience NMS, and many experience NMF. Prevalence rates for NMS using the MDS‐NMS are higher than on other scales used and increase with higher disease severity.

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“…[4][5][6][7] Its severity has been recently shown to increase the risk of mortality among Portuguese PD patients. 8 Despite being highly prevalent and potentially treatable, they are still insufficiently diagnosed and remain underrecognized in over 50% of the consultations performed by neurologists. 9 Frequently used scales and scores do not adequately detect these non-motor symptoms, 10 which make the development of an easy, fast and reliable NMS screening tool, imperative.…”

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Translation, Adaptation and Validation of the European Portuguese Version of the NMS-Quest for Parkinson’s Disease

2021

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Introduction: Non-motor symptoms are underrecognized features of Parkinson’s disease that impair quality of life and increase mortality. In this study, we aim to translate, adapt and validate the European Portuguese version of the “Non-Motor Symptoms Questionnaire”, which has proven to be a valid and reliable measurement tool of non-motor symptoms in other languages.Material and Methods: Acceptability was evaluated regarding the range of values, ceiling and floor effects. Reliability was measured in terms of internal consistency (Cronbach’s alpha) and reproducibility (intra-class correlation coefficient). For criterion validity analysis, Movement Disorders Society – Unified Parkinson’s Disease Part I domains’ scores were compared to those of the “Non-Motor Symptoms Questionnaire”. For convergent validity, correlations between the “Non-Motor Symptoms Questionnaire” and the Movement Disorders Society – Unified Parkinson’s Disease Part III, Mini-Mental State Examination score, disease duration, and severity were obtained.Results: Seventy nine Parkinson’s disease patients were recruited, with a mean age of 67.2 ± 10.7 years and a disease duration of 10.8 ± 8.8 years. The European Portuguese version of the “Non-Motor Symptoms Questionnaire” total score was free of significant ceiling and floor effects. With the exception of the cardiovascular domain, adequate overall internal consistency was achieved. The questionnaire domains and the corresponding Movement Disorders Society – Unified Parkinson’s Disease Part I dimensions were significantly correlated, although the total questionnaire score was modestly correlated with disease duration and severity, motor and non-motor symptoms severity and cognitive dysfunction.Discussion: This is the first study to translate, adapt and validate a widely used screening instrument of non-motor symptoms of European Portuguese speaking Parkinson’s disease patients.Conclusion: The European Portuguese version of “Non-Motor Symptoms Questionnaire” is a valid and reliable tool for screening nonmotor symptoms in patients with Parkinson’s disease.

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Motor and non-motor function predictors of mortality in Parkinson’s disease

Cited by 28 publications

References 29 publications

Increased Mortality in Young-Onset Parkinson’s Disease

Increased Mortality in Young-Onset Parkinson’s Disease

Prevalence of Non‐Motor Symptoms and Non‐Motor Fluctuations in Parkinson's Disease Using the MDS‐NMS

Translation, Adaptation and Validation of the European Portuguese Version of the NMS-Quest for Parkinson’s Disease

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