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

Abstract

Purpose This study aimed to determine predictors of health-related quality of life (HRQoL) in Parkinson's disease (PD) and to explore their predictive value before and after controlling overlapping items between HRQoL and clinical variables. Methods One hundred and eight PD patients underwent motor, anxiety, depression, apathy, fatigue, and neurocognition assessment. HRQoL was assessed by the Parkinson’s Disease Questionnaire-39 (PDQ-39). In order to determine predictors of HRQoL in PD, stepwise multiple regression analyses were performed in two ways: before and after removing the emotional well-being dimension from PDQ-39 to control the overlap between depression and anxiety, and HRQoL. Results HRQoL total index was predicted by anxiety, fatigue, motor symptoms, and depression, explaining 26.9%, 7.2%, 2.8%, and 1.9% of the variance. However, after removing overlapping items, HRQoL total index was predicted by fatigue (16.5%), anxiety (6.1%), motor symptoms (3.9%), and neurocognition (2.5%), but not depression. Regarding HRQoL dimensions, mobility and activities of daily living were predicted by fatigue (19.7% and 5%) and UPDRS-III (4% and 10.2%); emotional well-being by fatigue (7.9%); social support by anxiety (12.2%) and UPDRS-III (8.6%); communication by neurocognition (5.3%) and UPDRS-III (3.4%); cognition by anxiety (10.6%) and bodily discomfort by anxiety (23%) and fatigue (4.1%). Conclusion These findings showed the importance of identifying and controlling overlapping items of HRQoL and clinical measures to perform an accurate interpretation. HRQoL dimensions showed different predictors before and after controlling the overlap. Based on these results fatigue, anxiety, motor symptoms, and neurocognition, but not depression are the main predictors of HRQoL in PD patients.

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“…Being unable to accomplish these tasks may reduce autonomy and negatively impact QoL. Patients with other medical conditions have had their QoL and functional status predicted by their neurocognitive performance 36–38,63–65 . The participants with PCC in the present study, regardless of the severity of acute COVID‐19, showed impairments in global cognition (MoCA), verbal memory (RAVLT), and mental speed processing–executive function (Digit symbol test, TMT B, SCWT) compared with the control group.…”

Hypoxia Sensing and Responses in Parkinson’s Disease

“…In addition, several devastating symptoms, particularly non-motor symptoms such as fatigue, sleep disturbances, anxiety, depression, or impaired autonomic regulation cannot be effectively treated. However, these symptoms are important predictors of health-related quality of life in PD [7]. In addition to pharmacological strategies, deep-brain stimulation (often of the subthalamic nucleus and thereby dopaminergic neuronal networks) has emerged as a therapy of choice for a subgroup of patients.…”