Abstract
BackgroundThe objective of this study was to investigate factors affecting health-related quality of life (HRQoL) among Estonian persons with Parkinson’s disease (PD).Methods268 persons with PD were evaluated using: the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr scale (HY); the Schwab and England Activities of Daily Living scale (SE-ADL); the Beck Depression Inventory (BDI); the Mini Mental State Examination (MMSE); the Parkinson’s Disease Questionnaire (PDQ-39). Additional questions on clinical and socio-demographic variables were asked during a semi-structured interview. Predictors of HRQoL were tested using multiple regression analysis.ResultsThe main predictors of low HRQoL were depression and motor and non-motor aspects of daily living. 59.9 % of the variation in the PDQ-39 summary index (SI) score was explained by the predictive variables identified in this study. None of the socio-demographic variables (age, gender, urban/rural living, marital status, living alone/with others, education level) were significant predictors of HRQoL. Prevalence of non-motor Parkinson’s symptoms were high (99.6 %); cognitive impairment, sleep and urinary problems were the most common. All non-motor symptoms correlated significantly with low HRQoL, except the features of impulse control disorders (ICDs).ConclusionsDepression and motor and non-motor daily living experiences were found to be significant and independent factors of low HRQoL in persons with PD. Depression was the strongest determinant of low HRQoL. Our results highlight the importance of recognition and management of non-motor symptoms, as these features had more impact on patients’ HRQoL than clinically assessed motor symptoms.
Highlights
The objective of this study was to investigate factors affecting health-related quality of life (HRQoL) among Estonian persons with Parkinson’s disease (PD)
We focused on the non-motor symptoms identified by the new version of the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part I, which has recently been adopted and validated [10]
No significant differences in terms of PD onset age, disease duration, Hoehn and Yahr scale (HY) stage, SE-ADL stage or Mini Mental State Examination (MMSE) performance were found between men and women
Summary
The objective of this study was to investigate factors affecting health-related quality of life (HRQoL) among Estonian persons with Parkinson’s disease (PD). The symptoms of PD encompass motor features such as rigidity, bradykinesia, tremor and postural instability [2], and non-motor symptoms including impairment of olfaction, vision, sleep, salivation, gastric and bowel function, sebaceous gland activity, and mood and cognition [3]. PD diagnosis is based upon the presence of a set of cardinal motor signs; progression is defined by the Persons with PD are vulnerable to deterioration of health-related quality of life (HRQoL) resulting from significant motor disability and the burden of non-motor symptoms. The most significant determinants affecting HRQoL are disease severity, motor complications, postural instability and gait disorder [5,6,7]. Among non-motor symptoms, depression, anxiety, cognitive impairment, fatigue, pain, urinary disturbances and sleep problems were found to be the most
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