THE IMPACT OF NEUROPSYCHIATRIC SYMPTOMS ON QUALITY OF LIFE OF PATIENTS WITH PARKINSON’S DISEASE

Abstract

Background. The promising approach to Parkinson’s disease study in order to increase the therapeutic effectiveness is to update the symptoms that can affect the quality of life. The impact of neuropsychiatric symptoms (NPS) on different aspects of quality of life at different stages of disease is not studied. Purpose: to assess the impact of NPS on quality of life at different stages of PD. Patients and methods: One hundred and eighty eight (188) patients with Parkinson’s disease without dementia (95 males and 93 females) of 1–4 stages of disease were examined. The mean age was 63,84±0,6 years, mean stage of Parkinson’s disease was 2,6±0,3, PD duration consisted 6,3±4,1 years. We used the following tests and scales for assessment of motor and neuropsychiatric functions: UPDRS, the scale of Dyskinesias and motor fluctuations in Parkinson’s disease, Beck’s depression Inventory, the Spielberger State-Trait Anxiety Inventory, sleep scales, the Epworth sleepiness scale, fatigue scale (FSPD-16), cognitive functions scale in PD, the Lille apathy rating scale, and quality of life questionnaire in PD (QoLPD-39). Correlative analysis between motor and NP symptoms and outcomes concerning the quality of life was performed using Pearson’s correlation matrix and regression analysis. Results: The regression analysis revealed strong correlation between the total score of QoLPD-39 and depression, anxiety, fatigue and sleep disorders in patients with different severity of PD. We revealed strong correlation between the total score of QoLPD-39 and mobility, everyday activity, fatigue, trait anxiety, depression and sleep disorders in patients of 1–3 stages of disease. The correlation between movement disorders and total score of QoLPD-39 reached significant value only at the 3 and 4th stages of disease: at the third stage – there was correlation between total score and severity of “on-period” dyskinesias, at the forth disease stage – correlation between QoLPD-39 score and UPDRS outcomes of “Everyday activity” and “Movement function”, and severity of “off-period” dyskinesias. We revealed significant correlation between social and communicative aspects of quality of life and NPD, including apathy and hypersomnia at all disease stages. Conclusions: neuropsychiatric symptoms impact on the quality of life and movement and non-movement aspects of patient at all disease stages. Depression, anxiety, fatigue and sleep disorder are the main factors that affect the quality of life at all stages of PD. Apathy and excessive daytime somnolence decrease the social and communicative aspects of quality of life at different stages of PD.