Life In PD Patients Research Articles

Comparison of two questionnaires (PDQ-39 and SEIQoL) for assessment of the quality of life in idiopathic Parkinson’s disease

Parkinson’s disease is a neurodegenerative disease of the central nervous system that begins insidiously and progresses over time with a loss of nerve cells in certain brain regions. People with chronic diseases often experience a change in their quality of life. For patients, relatives, and the whole community, a reduced quality of life can pose a significant burden. Therefore, it is imperative to reduce socioeconomic costs to preserve high health quality in patients with neurodegenerative disorders. Parkinson’s disease can cause people to have difficulty performing daily activities such as working or shopping. It is not uncommon for social interaction to be impaired, as patients sometimes struggle to participate in social life due to their symptomatology. The quality of life of Parkinson’s disease patients can be measured in different ways. A distinction can be made between Health-related Quality of Life and Individualised Quality of Life. Several questionnaires and screening tools are investigating the Quality of Life in patients with Parkinson’s disease. However, their validity and practicability are often not extensively analyzed. In this paper, we will investigate whether the two questionnaires, “The Parkinson’s Disease Questionnaire (PDQ-39)” and “Schedule for the Evaluation of Individual Quality of Life (SEIQoL)”, measure the same quality of life in PD patients. The two questionnaires do not reach the same results, although they both measure the construct “Quality of Life” and should be used complementary to gain deeper insight into patients’ real-life problems.

Prevalence of Sexual Dysfunction in Parkinsonian Men: A Literature Review

ABSTRACT Introduction Parkinson's disease (PD) is one of the most common age-related progressive neurodegeneration disorders with incidence increasing 5-10-fold between the sixth to ninth decade of life. Aside from aging, the male sex is also a significant factor in developing PD. Men are twice as likely to develop PD, have an earlier age of disease onset, and an increased rate of disease progression than that of women. Recently, greater attention has been placed towards the quality of life in PD patients, of which non-motor symptoms play a significant role. Sexual dysfunction is an often-overlooked non-motor symptom, which requires patients to reinvent their sexuality thus forcing their partners to cope with these changes in addition to the consequences of Parkinson's disease. Although sexual dysfunction correlates with a reduced marital and life satisfaction, the dysfunction is neglected due to the sensitivity of the topic, prioritizing motor symptom complaints, and attitudes of patients. Objective The purpose of the study is to conduct a systemic review to evaluate the prevalence of the dominant sexual dysfunction characteristics in parkinsonian men to optimize their quality of life. Methods A systemic review was conducted according to the methodology following the PRISMA guidelines. A search was carried out across PubMed, CINAHL, Academic Search Complete, and PsychInfo using the term “Parkinson's disease” and “Sexual Dysfunction” with the latter expanded to include related terms such as “libido,” “low libido,” “impotence,” “erectile dysfunction,” “ejaculation,” and “orgasmic disorder.” There were no temporal or demographic restriction. Results A total of 956 references were identified, 428 were directed for reading titles and abstracts. A total of 81 articles were excluded for full-text reading. Based on inclusion and exclusion criteria, 15 studies met the criteria and were included into the review. The studies were published between 1990 and 2020. It was not possible to perform a meta-analysis due to the heterogeneity present in the studies. In the selected studies, six scales were used to measure sexual dysfunction: Arizona Sexual Experience Scale (ASEX), Brief Index for Sexual Function (BISF), International Index for Erectile Dysfunction (IIEF), Israeli Sexual Behavior Inventory (ISBI), Scales for Outcomes in Parkinson's Disease-Autonomic Dysfunction (SCOPA-AUT), and in-house questionnaires. Across the six sexual dysfunction scales, the average reported impaired libido was 40.93% (range = 2%-83%), erectile dysfunction was 54.27% (range = 21.05%-79%), ejaculatory dysfunction was 37.83% (range = 3.16%-79%), and orgasmic dysfunction was 47.88% (range = 0%-87%). Conclusions The review indicates a high prevalence of sexual dysfunction in parkinsonian men; however, insufficient evidence to support or refute the significance of the sexual dysfunction parameters in parkinsonian men. A link between Parkinson's disease and sexual dysfunction via dopamine deficiency and psychosocial deficits has been hypothesized. Increasing awareness and addressing the usually overlooked sexual dysfunction in parkinsonian men can potentially improve their quality of life significantly. Health care providers may consider initiating a conversation regarding sexual function or refer to a sexual medicine specialist thus optimizing the non-motor aspect of parkinsonian men's quality of life. Disclosure No

Gender based assessment of gait rhythms during dual-task in Parkinson’s disease and its early detection

Cognitive function and dual-task can reduce the quality of life in PD patients, but this relation of cognitive function and gait has some complications. To obtain more knowledge about the relation of cognitive function and gait, this study has been performed. This work gives male and female gait measures and their variability to determine the different attention-demanding resources for the control and PD groups. It gives the significant gait measures to predict risk of cognitive decline in near future. Twenty five PD patients (age – M = 70.94, F = 68.71) and fourteen controls (age – M = 73.87, F = 70.12 were included to analyzing the effect of dual-task. In both groups (male–female) of healthy and non-healthy gait speed decrease, but variability is more in the females. As expected, the results demonstrate that stance time and stride time increase for both groups in parallel fashion but swing time decrease. Stance and stride time are gait measures that play an essential role in gender-based PD analysis. Apart it, the present study gives an efficient classification technique for early detection of PD. Naïve Bayes classifier performed well with highest accuracy to distinguish the healthy and PD patients for both single task and dual task activities.

Impact of anticholinergic drugs withdrawal on motor function in patients with Parkinson’s disease

ObjectivesPhysicians have prescribed anticholinergic agents as monotherapy or adjuvant therapy in patients with Parkinson’s disease for decades. However, these medications can cause many adverse effects including gait freezing and falling. Herein we assessed the effects of anticholinergic medications on motor function, freezing of gait and falling in a group of patients with PD. Patients and MethodsThis prospective study evaluated the effect of gradual discontinuation of anticholinergics on motor function in 131 outpatients with Parkinson’s disease. We assessed patients’ motor function at baseline six and twelve months later using the UPDRS-III. We also evaluated freezing of gait and falling in patients using UPDRS-II part 14 and 13 respectively. The anticholinergics were tapered and gradually discontinued and additional levodopa doses were added as patients needed. Results131patients successfully discontinued their anticholinergic medications. Stopping anticholinergics significantly improved the motor symptoms in PD patients as reflected in the change between the mean (±SD) UPDRS-III score of 36.85(±11.5) at the baseline to 32.51(±11.4) and 31.43 (±11.3) after six and twelve months (P < 0.001). The mean (±SD) scores of freezing of gait (FOG)significantly changed from 1.34(±1) to 1.17(±1) and 0.6(±0.7) and for falling down from 0.62(±0.8) to 0.5 (±0.8) and 0.29(±0.5) respectively (p-value of <0.001). ConclusionOur finding demonstrated an improvement in motor function and FOG and falling incidences in PD patients, after discontinuation of anticholinergic drugs. As motor complications adversely affect the quality of life in PD patients, clinicians must be careful with the unnecessary use of anticholinergic drugs in their treatment strategies.

Multiple comorbid sleep disorders adversely affect quality of life in Parkinson\u2019s disease patients

Sleep disorders are common non-motor symptoms in patients with Parkinson’s disease (PD). The characteristics and impact of multiple comorbid sleep disorders remain to be elucidated. Our goal was to investigate the characteristics of various sleep disorder comorbidities, and their association with motor complications and the impact on the quality of life in PD patients. In this multicenter, observational, cross-sectional study, data concerning the clinical characteristics of complicated sleep disorders were collected from PD patients treated at 40 different hospitals in Shanghai. Sleep disorders were evaluated using the PD Sleep Scale-2, Epworth Sleepiness Scale, Rapid Eye Movement Sleep Behavior Disorder Questionnaire-Hong Kong, and the International Restless Legs Scale. Among the 1006 subjects evaluated, 77.53% exhibited signs of sleep disorders, and most had multiple sleep disorders (n = 502, 49.9%). A smaller percentage of patients with sleep disorders had a single disorder (n = 278, 27.6%). Furthermore, an increased number of sleep disorders, including nighttime problems, excessive daytime sleepiness, rapid eye movement sleep behavior disorder, and restless legs syndrome was a significant contributor to a poor quality of life (β = 4.33, CI: 3.33–5.33, P for trend <0.001), even when controlling for multiple factors. Moreover, motor complications partially mediated this relationship (indirect effect: β = 0.355, 95% boot CI: 0.134, 0.652).Our study showed that a large proportion of PD patients suffer from multiple comorbid sleep disorders, which greatly decreases the quality of life in PD patients and is partially mediated by motor complications.

EFFECTS OF PHYSIOTHERAPY INTERVENTIONS ON FALL, POSTURE AND QUALITY OF LIFE IN PARKINSON DISEASE

BACKGROUND AND AIMS Parkinson disease is the 2nd most common neurological disorder worldwide that is mainly associated with motor system. The role of non-pharmacological treatment in the management of fall, posture and improving quality of life is yet unclear therefore this review was conducted to evaluate the effects of physiotherapy interventions on fall, posture and quality of life in PD patients. DATABASES AND ELIGIBILITY CRITERIA A literature search was conducted through Google Scholar, PEDro, Cochrane Library, Med-line, CINAHL, Web of Science and PubMed included 18 randomized controlled trials evaluating physiotherapy interventions effects on fall, posture or QOL in PD patients that published in the year 2010 to onwards 2019 were included. RESULTS Methodological quality and risk of bias was assessed using the Cochrane tool for assessing risk of bias. The findings revealed that PT treatments like resistance training, balance exercises, exergaming and low-intensity trunk exercises are effectual in enhancing QOL and postural imbalance. However resistance strength training, fall education and gait training more effectively reduces fall. CONCLUSION Physiotherapy interventions play an essential role in the treatment of fall, postural imbalance and QOL. These interventions should be integrated in the treatment plan so that PD patients can achieve greater independence in their lives.

Physical neurorehabilitation therapy in Parkinson's disease “OFF” period

The aim of this study was to evaluate the short-term effects of the physical neurorehabilitation therapy among PD patients “OFF” period especially on balance, walking and quality of life. Eight patients (59 ± 10 years) at a moderate stage (the pre- and post-tests in “OFF” period) (12 hours after the last dopaminergic intake) consisted of the clinical assessment of balance control ability by the tests of Tinetti, Timed “Up and Go” test (TUG) and the instrumental evaluation with posturography that was done in both eyes-opened (EO) and eyes-closed (EC) conditions. The walking test was performed by the 6-minute walk test (6MWT) as well as a recording by the locometer. Quality of life assessment was done through UPDRS III. The protocol is based on an asymmetric motor strengthening targeted at the opener muscles by using resistance that is increased progressively. Those exercises were combined with stretching postures for the closer muscles. Finally, work was completed in occupational therapy to regain autonomy and increase functional performance. We observed a significant improvement in balance by the Tinetti test ( P < 0.01) and the TUG ( P < 0.01) while there was a decrease of the anteroposterior movements of the pressure center OE and CE ( P < 0.05). We noticed a significant effect on walking parameters with an increase in the average walking perimeter ( P < 0.01) at 6MWT and in the stride length, cadence, walking speed ( P < 0.05) collected by the locometer. These results had a positive impact on the quality of life with significant improvement in the UPDRS scale ( P < 0.05). The physical neurorehabilitation therapy provides good results on balance, walking and quality of life in PD patients. Further prospective clinical studies with larger number of patients and more longer duration of follow-up are needed to confirm our results.

Orthostatic Hypotension in Patients with Parkinson’s Disease and Atypical Parkinsonism

Orthostatic hypotension (OH) is one of the commonly occurring nonmotor symptoms in patients with idiopathic Parkinson's disease (IPD) and atypical parkinsonism (AP). We aimed to review current evidences on epidemiology, diagnosis, treatment, and prognosis of OH in patients with IPD and AP. Major electronic medical databases were assessed including PubMed/MEDLINE and Embase up to February 2013. English-written original or review articles with keywords such as “Parkinson's disease,” “atypical parkinsonism,” and “orthostatic hypotension” were searched for relevant evidences. We addressed different issues such as OH definition, epidemiologic characteristics, pathophysiology, testing and diagnosis, risk factors for symptomatic OH, OH as an early sign of IPD, prognosis, and treatment options of OH in parkinsonian syndromes. Symptomatic OH is present in up to 30% of IPD, 80% of multiple system atrophy (MSA), and 27% of other AP patients. OH may herald the onset of PD before cardinal motor symptoms and our review emphasises the importance of its timely diagnosis (even as one preclinical marker) and multifactorial treatment, starting with patient education and lifestyle approach. Advancing age, male sex, disease severity, and duration and subtype of motor symptoms are predisposing factors. OH increases the risk of falls, which affects the quality of life in PD patients.

Declining Quality of Life in Parkinson Disease Before and After Diagnosis

We sought to assess the quality of life in PD patients before the diagnosis, in comparison to age-matched individuals free of PD, among participants in two large prospective cohorts of men and women. Components of the Short-Form Health Status Survey (SF36) were administered to all participants in 1996 and 2008 in the Health Professionals Follow-up Study (HPFS), and in 1992, 1996, 2000 and 2004 in the Nurses' Health Study (NHS). We used scores in 7 health-related quality of life-dimensions, that were rated from 1(worst) to 100(best) points. We fitted a multivariate mixed-effect model with repeated measures to estimate the expected decline with age and compared that to the decline observed among PD cases by time to diagnosis. 454 men and 414 women with PD contributed data to the analyses. A decline in physical function in PD patients relative to the whole cohort began approximately 7.5 years prior to diagnosis in women and 3 years prior to diagnosis in men, and continued to decline thereafter with a rate of 2.35 and 1.43 points per year in women and men respectively (p < 0.001 for both). For comparison, the average yearly decline in individuals without PD was 0.42 and 0.23 points per year in women and men respectively. Other measures of quality of life (only available in women) declined in a similar pattern to physical function. In summary, the quality of life in PD patients begins to decline years before the diagnosis.

Investigation on risk factors of depression and anxiety in parkinson's patient and nursing

Objective To investigate risk factors of depression and anxiety in parkinson' s patient and explore related nursing strategy. Methods A face-to-face interview was taken in patients who were awake. The minimental state examination (MMSE), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Rating Scale(HAMD) were jointly accomplished by doctors, patients, their families, and nurses. Non-conditional Logistic regression model was used. Results Regression analysis showed that depressive and anxiety in PD patients was positively related with the course of disease, movement disorder parkinson' s patients (UPDRS),degree of cognitive impairment. The movement disorder in parkinson' s patients, the course of disease, duration of the occurrence of anxiety and depression risk factors were greater than one, and the age and UPDRS were significantly different in the occurrence of anxiety and depression. Conclusions Attention to patients with PD changes in depression and anxiety, enhance disease health education and rehabilitation training to improve the health quality of life of PD patients. Key words: Parkinson's disease; Depression; Anxiety; Risk factors; Nursing