Quality of life in Parkinson's disease: The relative importance of the symptoms

Abstract

A body of literature now exists, which demonstrates that idiopathic Parkinson's disease (PD) has a major negative impact on quality of life (QoL), and that depression and cognitive impairment are among the main predictors of poor QoL in this disorder. Relatively little work has been done to assess the differential contribution of the specific symptoms of PD to QoL, which was the aim of this study. One hundred thirty patients with PD completed a booklet of questionnaires, which included the PDQ39 as a disease-specific measure of QoL, a symptom checklist, a mobility checklist, as well as patient ratings of disease stage and disability. The results indicated that the contribution of physical, medication-related, and cognitive/psychiatric symptoms to QoL can be significant. Sudden unpredictable on/off states, difficulty in dressing, difficulty in walking, falls, depression, and confusion were PD symptoms, which significantly influenced QoL scores. Among the mobility problems associated with PD, start hesitation, shuffling gait, freezing, festination, propulsion, and difficulty in turning had a significant effect on QoL scores. In addition to depression and anxiety, the major predictors of QoL were shuffling, difficulty turning, falls, difficulty in dressing, fatigue, confusion, autonomic disturbance particularly urinary incontinence, unpredictable on/off fluctuations, and sensory symptoms such as pain. The implications of these results for the medical management of PD are discussed.

Falls in people with Parkinson’s disease: A prospective comparison of community and home-based falls

“…Falls can have devastating consequences including restriction or avoidance of physical activities [2,3] and reduced health-related quality of life [4].…”

A systematic review of treatments for Impulse Control Disorders and related behaviours in Parkinson׳s disease

“…These symptoms can be broadly classified into neuropsychiatric problems (including disturbances in cognition and mood), sleep disturbances and autonomic symptoms. These non-motor symptoms commonly dominate the clinical picture in severe PD and, as such, have a significant impact on quality of life and disability (Rahman et al, 2008). The pathophysiology of these symptoms remains poorly understood.…”

WHOQOL-OLD assessment of quality of life in elderly patients with Parkinson's disease: influence of sleep and depressive symptoms

“…[4][5][6][7] In PD patients, disability can result from distinct features such as motor impairment, non-motor complications, 4,8 and treatment side effects. Studies have shown that PD-related motor symptoms, [9][10][11][12][13] affective disorder, [13][14][15][16][17] and cognitive dysfunction 14 can be determinants of quality of life. According to the World Health Organization (WHO), quality of life (QOL) is "individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns".…”