Abstract
This study examined whether activities of daily living (ADL) mediate the relationship between depression and health-related quality of life (HR-QOL) in people with Parkinson's disease (PD). A cross-sectional, correlational research design examined data from 174 participants who completed the Geriatric Depression Scale (GDS-15), Parkinson's Disease Questionnaire-39 (PDQ-39), and Unified Parkinson's Disease Rating Scale-section 2 (UPDRS-section 2 [ADL]). Multiple Regression Analysis (MRA) was used to examine the mediator model. Depression and ADL significantly (p<.001) predicted HR-QOL, and depression significantly (p<.001) predicted ADL. Whilst ADL did not impact on the relationship between depression and HR-QOL, there was a significant (p<.001) indirect effect of depression on HR-QOL via ADL, suggesting both direct and indirect (via ADL) effects of depression on HR-QOL. The magnitude of this effect was moderate (R 2 = .13). People with PD who report depression also experience greater difficulty completing ADL, which impacts upon their HR-QOL. It is recommended that clinicians adopt a multidisciplinary approach to care by combining pharmacological treatments with psycho/occupational therapy, thereby alleviating the heterogeneous impact of motor and non-motor symptoms on HR-QOL in people with PD.
Highlights
In addition to the cardinal motor symptoms of Parkinson’s disease (PD), approximately 42% of people with PD report depressive symptoms [1]
Bivariate correlations determined whether age significantly correlated with depression, activities of daily living (ADL), and health-related quality of life (HR-QOL)
As predicted (Hypothesis 1), depression significantly correlated with HR-QOL and ADL
Summary
In addition to the cardinal motor symptoms of Parkinson’s disease (PD), approximately 42% of people with PD report depressive symptoms [1]. Research suggests that comorbid depression in PD adversely impacts both health-related quality of life (HR-QOL) and the capacity to complete activities of daily living (ADL) [2]. Body discomfort and pain are common consequences of PD, which can lead to social isolation and negatively impact HR-QOL [3]. Depression is a strong predictor of poor HR-QOL in PD [4]. Quelhas and Costa [4] and Carod-Artal et al [6] found that depressed participants had poorer HR-QOL compared to nondepressed participants. Depression may be a more significant predictor of HR-QOL in PD than motor symptoms [5]
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