Abstract
The aim of this study was to examine the relationships among depression, anxiety, sleep disturbances, Parkinson's disease (PD) symptoms, PD medications, and health-related quality of life (QOL) and to identify the predictors of health-related QOL in PD patients. To do this, we administered a battery of questionnaires and rating scales (validated Chinese versions), including the Unified Parkinson's Disease Rating Scale, 39-item Parkinson's Disease Questionnaire, Parkinson's Disease Sleep Scale-2, Beck Depression Inventory, and Beck Anxiety Inventory, to 134 patients with PD whose Minimental State Examination scores were ≥24. We found that patients who reported having poorer QOL had longer disease durations, more severe PD symptoms, higher Hoehn and Yahr stages, and higher levodopa dosages, as well as higher levels of anxiety and depression, more sleep disturbances, and poorer overall cognitive statuses. Among these variables, the cognitive status, dependency of activities of daily living, depression, and anxiety were identified as predictors of QOL in PD patients and were all significant and independent factors of poor QOL in PD patients. The clinicians should be aware of the effects of these factors on QOL and attempt to treat comorbid psychiatric conditions to improve the PD patients' QOL.
Highlights
Parkinson’s disease (PD) is primarily considered to be a movement disorder, with a prevalence of about 1% in individuals over 60 years of age [1]
Previous studies have shown that the prevalence of nonmotor symptoms such as depression, anxiety, and sleep disturbances is higher in patients with PD than in the general population [4,5,6,7,8,9,10,11,12]
Our study demonstrated that PD patients who reported poorer quality of life (QOL) had longer disease durations, more severe PD symptoms, higher Hoehn and Yahr stages, and higher levodopa dosages, as well as higher levels of anxiety and depression, more sleep disturbances, and poorer overall cognitive statuses
Summary
Parkinson’s disease (PD) is primarily considered to be a movement disorder, with a prevalence of about 1% in individuals over 60 years of age [1]. Previous studies have shown that the prevalence of nonmotor symptoms such as depression, anxiety, and sleep disturbances is higher in patients with PD than in the general population [4,5,6,7,8,9,10,11,12]. In addition to depression and anxiety, sleep disturbances, such as poor sleep quality, excessive daytime sleepiness, delays in falling asleep, and difficulty staying asleep, have been estimated to occur in ∼60–98% of patients with PD [8, 9]. It is unclear whether these nonmotor symptoms share common pathophysiological mechanisms [10]. Some studies have shown that mood disorders are negatively correlated with sleep disturbances in patients with PD [13, 14]
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