Abstract
The most frequently used instrument to assess health-related quality of life (HrQoL) in Parkinson's disease (PD) is the Parkinson's Disease Questionnaire 39 (PDQ-39). However, both the dimensionality of the eight PDQ-39 subscales and their summary score recently faced criticism. Furthermore, data on disease-related and neuropsychological determinants and the role of gender on HrQoL in PD are inconclusive yet. Therefore, our aim was to reevaluate the PDQ-39 structure and to further explore determinants of HrQoL in PD. 245 PD patients (age: M = 69.64, SD = 8.43; 62.9% male; H&Y: Md = 3.00; cognitive assessment with PANDA: M = 24.82, SD = 3.57) from the baseline database of the Cologne Parkinson Network were used to reevaluate the dimensionality of the PDQ-39 with a principal component analysis (PCA). Multiple regression analyses were conducted to clarify general and domain-specific relationships between clinical, (neuro)psychological, and sociodemographic variables, gender in particular, and HrQoL. The PCA identified three HrQoL domains: physical-functioning, cognition, and socioemotional HrQoL. Depressive symptoms were identified as the most important determinant of HrQoL across all models. Disease-related HrQoL determinants (UPDRS-III, H&Y stage, and LEDD) were less strong and consistent HrQoL determinants than nonmotor symptoms. Analyses did not reveal a global gender effect; however, female gender was a negative predictor for physical-functioning and socioemotional HrQoL, whereas male gender was a negative predictor for cognition HrQoL. Our analyses suggest the consideration of a reevaluation of the PDQ-39. Only the full understanding of HrQoL, its determinants, and their interrelationships will allow the development of PD intervention strategies focusing on what matters the most for patients' HrQoL. Gender is one relevant variable that should be considered in this context.
Highlights
Still considered as a paradigmatic movement disorder, Parkinson’s disease (PD) is associated with cognitive dysfunctions, depressive symptoms, and a broad spectrum of other nonmotor symptoms (NMS; [1]), as well
Data on disease-related and neuropsychological determinants and the role of gender on health-related quality of life (HrQoL) in PD are inconclusive yet. erefore, our aim was to reevaluate the Parkinson’s Disease Questionnaire 39 (PDQ-39) structure and to further explore determinants of HrQoL in PD. 245 PD patients from the baseline database of the Cologne Parkinson Network were used to reevaluate the dimensionality of the PDQ-39 with a principal component analysis (PCA)
Our analyses suggest the consideration of a reevaluation of the PDQ-39
Summary
Still considered as a paradigmatic movement disorder, Parkinson’s disease (PD) is associated with cognitive dysfunctions, depressive symptoms, and a broad spectrum of other nonmotor symptoms (NMS; [1]), as well. To assess HrQoL as a health outcome in PD patients, the Parkinson’s Disease Questionnaire 39 (PDQ-39; [5, 6]) was identified as the most appropriate, thoroughly tested, and used questionnaire [7]. E PDQ-39 comprises eight HrQoL subscales [5], commonly summarized by a PDQ-39 summary score [6]. The eight-dimensional structure of the PDQ-39 faces criticism to be over-complex and the integration of HrQoL dimensions to a more theoretical framework is demanded [9]. Erefore, one goal of this study was to summarize the eight predefined HrQoL domains to a more meaningful and less complex domain structure based The eight-dimensional structure of the PDQ-39 faces criticism to be over-complex and the integration of HrQoL dimensions to a more theoretical framework is demanded [9]. erefore, one goal of this study was to summarize the eight predefined HrQoL domains to a more meaningful and less complex domain structure based
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