Predictors and course of health‐related quality of life in Parkinson's disease

Abstract

We investigated how health related quality of life (HRQL) changes over time in a population-based cohort of patients with Parkinson's disease (PD), and which factors predict a lower level of HRQL in these patients. Of 227 patients with PD assessed at baseline and followed prospectively, information on HRQL-status was obtained in 111 subjects 4 years and 82 patients 8 years after inclusion. HRQL was measured by the Nottingham Health Profile (NHP). Analyses were conducted using generalized estimating equation models. The NHP total score (P < 0.001) and scores in all NHP dimensions except for sleep worsened significantly during follow-up. Steepest slope was found for the domain physical mobility (3.16, 95% CI 2.39-3.92), followed by the domains social isolation (2.22, 95% CI 1.52-2.93) and emotional reactions (1.36, 95% CI 0.74-1.97). In addition to follow-up time, higher Hoehn and Yahr staging, higher Montgomery and Aasberg Depression Rating Scale scores, and presence of insomnia at baseline were associated with lower levels of overall HRQL during follow-up. We conclude that PD has an increasing impact on HRQL as the disease progresses. During long-term follow-up, deterioration in physical mobility was the most important single factor contributing to decline in HRQL in our cohort, although distress of nonmotor character as a whole outweighed the impact of distress in physical mobility on overall HRQL. More advanced disease, higher severity of depressive symptoms, and presence of insomnia were found to be important and independent predictors of poor HRQL. (c) 2008 Movement Disorder Society.

Measuring participation in individuals with Parkinson disease: relationships with disease severity, quality of life, and mobility

“…The mobility section of the PDQ-39 demonstrated an even stronger inverse relationship with the ACS. It has been previously established that mobility plays a significant role in QOL [41][42][43][44]; however, until now mobility-related QOL has not yet been examined in relation to participation in activities. This study shows that those with decreased QOL participate less in a wide range of activities with a strong specific relationship for mobility.…”

Developing consensus among movement disorder specialists on clinical indicators for identification and management of advanced Parkinson’s disease: a multi-country Delphi-panel approach

“…The current study was aimed to achieve consensus among movement disorder specialists treating PD patients with regard to the following objectives: (i) identify the clinically important indicators that define APD, (ii) identify patient characteristics that indicate eligibility for deviceaided therapy options in PD, and (iii) identify an appropriate patient profile for different device-aided therapy options in PD: CSAI, DBS, and LCIG. Identifying key indicators of patients transitioning to APD or with suspected APD is important for timely referral and intervention 4,8,[22][23][24] . Our study adds to recent emerging literature which aims to generate consensus around identifying key symptoms of APD, and identifying indicators of when oral/transdermal medications are no longer effectively controlling symptoms to aid in practical management of the APD patients in clinical practice 4,16 .…”

Using the WHOQOL-DIS to Measure Quality of Life in Persons with Physical Disabilities Caused by Neurodegenerative Disorders

“…Compared with the general population, persons with MS [5] and PD [6] report lower levels of HRQoL in terms of emotional, physical and social functioning. Factors consistently found to affect the HRQoL in MS and PD include significant depressive symptoms [7,8] and disabilities [8,9,10]. …”