Clinical and psychosocial factors associated with fatigue in patients with Parkinson's disease

Abstract

Fatigue is an important contributor to poor quality of life. The aim of our research was to identify factors associated with fatigue among patients with Parkinson's disease (PD). The sample consisted of 150 patients. The Multidimensional Fatigue Inventory (MFI), Unified Parkinson's Disease Rating Scale (UPDRS), Hospital Anxiety and Depression Scale (HADS) and Charlson co-morbidity index were used for analysis. Demographic data were obtained in a structured interview. T-test, chi(2)-test and general linear regression were used. Fatigue was reported in 81% of the patients, with the worst scores in physical fatigue. Mood disorders and worse UPDRS scores were associated with fatigue.

Clinical determinants of primary and secondary fatigue in patients with Parkinson’s disease

“…The higher prevalence of fatigue in PD, however, cannot be explained only by older age. In contrast with our finding, most previous studies found no association between older age and fatigue in PD [11,17]. A recent study on fatigue in early PD found a significant correlation between higher fatigue scores and older age, but when linear regression analysis was applied, only depression and UPDRS activities of daily living subscale remained significant in their population [38].…”

“…We found the prevalence of fatigue to be higher than is described in previous studies [15][16][17], which mostly used uni-dimensional fatigue rating scales. MFI scores and the prevalence of fatigue are significantly higher in the physical domains of fatigue in both groups than in the mental domains, which could be explained by the stronger impact of core motor features of PD on the physical abilities of patients [11]. Both primary and secondary fatigue differed significantly in baseline characteristics and factors associated with different fatigue domains.…”

“…Indeed, fatigue is present in all PD stages and was previously found in one-third of newly diagnosed untreated, non-demented and non-depressed PD patients [15]. Most previously published articles found a strong link between fatigue and the presence of mood disorders, especially depression [11,13,14] and excessive daytime sleepiness (EDS) [16,17]. Here is some overlap, since fatigue is one of the DSM-IV diagnostic criteria for depression and anxiety, making interpretation of fatigue in the presence of such problems a major challenge.…”

“…One reason is the probable heterogeneity of biological, clinical and psychosocial factors leading to the presence of fatigue. In previous studies, disease severity, as measured by the Unified Parkinson's Disease Rating Scale (UPDRS), was associated with fatigue only in some studies [11,12], while others found no such association [13,14]. A significant association between disease duration and fatigue has not yet been proven.…”

Effects of Physical Activity Levels on Fatigue Perception in Patients with Parkinson’s Disease and Neurologically Healthy Individuals

“…Fatigue is multifactorial and has been set as a general sense of tiredness or difficulties in starting an activity on the physical or mental sector experienced by an individual during many days or weeks [5]. Nearly 58% of patients with PD present fatigue [2] [6], with higher incidence in advanced stages of PD [7]. Fatigue is linked with serotonergic dysfunction in basal ganglia and limbic circuits [8] [9], and in thalamus, additional cortical and striatal regions [10].…”