Predictors of clinically significant quality of life impairment in Parkinson’s disease

Abstract

Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.

Predictors of the change in burden, strain, mood, and quality of life among caregivers of Parkinson's disease patients

“…Comparing with the existing literature, our results are novel in observing that after a 2‐year of follow‐up, QoL, mood, burden, and strain impaired in the caregivers of PD patient. Previously, we had reported an impairment in NMS burden, QoL, and autonomy for ADL in PD patients from this cohort after a 2‐year follow‐up 35–37 …”

Predictors of health-related quality of life in Parkinson’s disease: the impact of overlap between health-related quality of life and clinical measures

“…For future research, longitudinal analyses would be needed to determine if the predictive symptom intervention could affect HRQoL. In fact, a recent longitudinal study examining predictors of HRQoL impairment in PD patients showed that, after a 2-year follow-up, age, sex, mood, and non-motor impairment were associated with clinically significant HRQoL impairment in PD patients [ 72 ]. On the other hand, the HRQoL evaluated using PDQ-39 does not allow to contrast the results with other pathologies, since the PDQ-39 is a specific PD scale.…”

Vortioxetine Improves Depressive Symptoms and Cognition in Parkinson’s Disease Patients with Major Depression: An Open-Label Prospective Study

“…Depression occurs in around 35% of patients with PD and is often persistent [ 39 ]. Many cross-sectional and prospective longitudinal studies have demonstrated that depression is a key factor impacting not only patients’ QoL, but also principal caregivers’ QoL too [ 3 , 40 , 41 , 42 ]. The underlying mechanisms of depression in PD are not known in detail, but changes in brain structure, signaling by neurotransmitters, and levels of inflammatory and neurotrophic factors are all suggested to contribute to its development [ 39 , 43 ].…”