Abstract
The objective of this study was to investigate the impact of levodopa therapy-induced complications on the quality of life (QoL) of Parkinson’s disease (PD) patients in Singapore over a 1-year follow-up period. 274 PD patients were prospectively recruited, of which 78 patients completed the follow-up. Patients were evaluated on: (1) motor symptoms, (2) non-motor symptoms, (3) levodopa therapy-induced complications and (4) QoL. Levodopa-induced complications including dyskinesia and OFF symptoms occurred in 13.5% and 55.9% of the study population, respectively. In patients who completed the 1-year follow-up, there was a trend suggestive of increasing dyskinesia duration, more disabling dyskinesia as well as longer, more sudden and unpredictable OFF periods. There was a significant decline in the overall QoL at follow-up, in particular, activities of daily living, emotional well-being, cognition and communication domains were the most affected. The multivariable analysis demonstrated that worsening of UPDRS IV total score over 1-year interval was associated with worsening in PDQ-Summary Index score (d = 0.671, p = 0.014). In conclusion, levodopa-induced complications had significant adverse impacts on QoL. This study substantiates the importance for clinicians to closely monitor and promptly manage levodopa therapy-induced complications that may arise in patients.
Highlights
Parkinson’s disease (PD) is the second-most prevalent neurodegenerative disease in the world, with the average age of onset of approximately 60 years[1]
To the best of our knowledge, this short-term longitudinal study is one of the first examining the impact of levodopa therapy-induced complications on quality of life (QoL) in PD patients in a multi-ethnic Asian population like Singapore’s
The majority of other studies have been non-longitudinal and conducted on non-Asian populations[7,8,9,10], while relatively few examined the determinants of QoL in PD patients in Chinese or predominantly Chinese populations[11,12]
Summary
Parkinson’s disease (PD) is the second-most prevalent neurodegenerative disease in the world, with the average age of onset of approximately 60 years[1]. It is most consistently linked with aging, and the global burden of PD is expected to increase sharply in future as life expectancies increase and demographics change[2]. The primary aim of this study was to determine the impact of levodopa therapy-induced complications on the quality of life of PD patients over a 1-year follow-up period
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