Non-Motor Symptoms as Predictors of Quality of Life in Egyptian Patients With Parkinson's Disease: A Cross-Sectional Study Using a Culturally Adapted 39-Item Parkinson's Disease Questionnaire.

Ali S Shalash,Samia Ashour,Hanan Hani Elrassas,Eman Hamid,Abdelrahman Ibrahim Abushouk,Nahed Salah-Eldin Ahmed,Mostafa Hashim,Mohamed Khamis,Ahmed Safwat Bedair,Mahmoud Elbalkimy

doi:10.3389/fneur.2018.00357

Abstract

The prevalence of non-motor symptoms (NMSs) and their impact on health-related quality of life (HRQoL) in Parkinson's disease (PD) has been reported inconsistently among different populations. In this study, we aimed to investigate the NMSs and HRQoL profiles and their correlation in Egyptian PD patients, using a culturally adapted Arabic version of the 39-item Parkinson's disease questionnaire (PDQ-39). Ninety-seven PD patients were rated using the unified Parkinson's disease rating scale (UPDRS), the non-motor symptoms scales (NMSS), Beck depression inventory (BDI), and the Arabic version of PDQ-39. We used the Spearman's rank correlation and multiple linear regression analyses to evaluate the relationship between NMSs domains and HRQoL dimensions. Fatigue/sleep (91.3%) and mood/cognitive disturbances (87%) were the most frequently and severely affected NMSS domains. Other common NMSs included urinary (75.9%), memory/attention (72.4%), gastrointestinal (67.8%), and cardiovascular problems (64.8%). The total NMSS scores were positively correlated with UPDRS I, II, and III scores. Depression was prevalent in 76.7% of PD patients. Moreover, all enrolled PD patients reported impairment in different HRQoL dimensions, especially mobility (98.9%), activities of daily living (97.8%), and emotional well-being (95.5%). The summary index of PDQ-39 was correlated to the total NMSS, UPDRS-I, UPDRS-II Off, UPDRS-III (Off and On states), and BDI scores. This study showed the high prevalence of NMSs and the value of NMSS and BDI scores as predictors of HRQoL in Egyptian PD patients. Therefore, characterizing the NMSs profile is essential for tailoring management strategies for PD patients.

Highlights

Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide, caused by degeneration of dopaminergic neurons in the substantia nigra, and affects approximately 1–3% of the elderly population (≥60 years) [1]
Ninety-seven patients diagnosed with idiopathic PD were recruited from the movement disorders outpatient clinic at Ain Shams University Hospitals (Cairo, Egypt) between 2013 and 2017
Ninety-seven PD [58 males (59.8%) and 39 females (40.2%)] patients were enrolled in this cross-sectional study

Summary

Introduction

Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide, caused by degeneration of dopaminergic neurons in the substantia nigra, and affects approximately 1–3% of the elderly population (≥60 years) [1]. The NMSs consist of autonomic dysfunction, sensory symptoms, neuropsychiatric disturbances, sleep problems, fatigue, and gastrointestinal (GIT) disorders. Their impact on HRQoL was reported to be greater than the motor symptoms of PD [3]. Another study showed that bodily discomfort and stigma were the most impaired HRQoL domains among Chinese PD patients, in contrast to other populations [9]. These differences could be attributed to several demographic, genetic, and clinical variations in PD patients [10]. Identifying the prevalent NMS subtype in various settings will help to personalize the management of PD patients [12]

Methods

Results

Conclusion