Predictors of clinically significant quality of life impairment in Parkinson\u2019s disease

Diego Santos‐García ,Sonia Lastres Gómez,Ana Golpe Díaz,Cristina García Campos,Berta Solano Vila,Noemí Bernardo Lambrich,Melva Lage Castro,Víctor Puente,María A Ávila Rivera,Isabel González Aramburu,María P Gómez Garre,Helana Bejr-Kasem,Araceli Alonso Cánovas,A Cámara Lorenzo,Elena Estelrich Peyret,Ignacio Álvarez,Pilar Sánchez Alonso,Carlos Ordás,Marta Almeria,Sonia Escalante,Pedro Gámez,Javier Rúiz Martínez,Mireia Grau Solá,Nuria López Ariztegui,Ane Crespo Cuevas,Itziar Gastón,Ruben Alonso Redondo,Juan García Caldentey,Manuel Seijo,Jessica González Ardura,Jorge Hernández Vara,Daniel Idoate Calderón,Víctor Nogueira,Fátima Carrillo,Sonia Arribas,Ester Suárez,Caridad Valero,Cristina Martínez Miró,Silvia Jesús,Francisco Carrillo Padilla,Mónica Kurtis,Carmen Borrué,Carlos Cores,Javier González Aloy,González Toledo,Teresa De Deus Fonticoba,Maria G Alonso Losada,Luis M López Díaz,Arancha Ascunce Vidondo,Guillermo Muñoz,Noelia Fernández Guillán,Sandra Arnáiz,Marta Blázquez Estrada,Héctor Canfield Medina,Marina Cosgaya,Pablo Mir,Anna Cots Foraster,Esther Cubo,Jon Infante,Mercedes Gallego,Miguel A Labrador,Jaime Kulisevsky,Fernando Alonso Frech ,Julio Dotor García‐Soto ,Pablo Martı́nez-Martı́n ,Juan Carlos Martínez Castrillo ,Núria Caballol ,A Cortina Fernández ,Mónica Díez-Fairén ,Luis Manzanares ,Oriol De Fábregues ,Lluís Planellás ,José Manuel García Moreno ,Víctor Gómez‐Mayordomo ,Pau Pástor ,Inés Legarda ,Andrea Horta‐Barba ,María José Catalán ,Null Author_Id ,Francisco Agramunt Lacruz ,A Aneiros Díaz ,María Álvarez Saúco ,Jose Manuel Paz González ,Elena Casas Peña ,María Ruiz De Arcos ,María José González Palmás ,B González García ,María Teresa Buongiorno ,Raquel Gabriel ,Mariángeles Botí ,Carmen M Labandeira ,G Guardia ,Carolina Cabello ,Lydia Vela,Darrian Mcafee,Miquel Aguilar,Pedro Clavero,Elena Erro,Iria Cabo,B López Seoane

doi:10.1038/s41531-021-00256-w

Abstract

Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.

Highlights

Parkinson’s disease (PD) is a complex disorder in which different motor and non-motor symptoms (NMS) can be present with a frequency and severity that varies among patients over time[1]
The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% at V2 (Table 1 and Fig. 1)
PD patients who presented at the 2-year follow-up a clinically significant HRQoL impairment presented a 97.3% increase of the NMS burden (NMSS total score from 29.2 ± 25.87 to 57.84 ± 46.73 [p < 0.0001]) compared to 8.6% in those patients who did not (NMSS total score from 48.38 ± 38.59 to 52.53 ± 41.35 [p = 0.003]) (Fig. 2A)

Summary

Introduction

Parkinson’s disease (PD) is a complex disorder in which different motor and non-motor symptoms (NMS) can be present with a frequency and severity that varies among patients over time[1]. Both motor and NMS are important because they negatively impact the patient’s quality of life (QoL). Global perceived QoL (GQoL) in non-demented PD patients from the Spanish cohort COPPADIS14. These results aligned with other cross-sectional studies observations[15,16,17].

Objectives

Results

Conclusion