Impact of non-motor symptoms on health-related and perceived quality of life in Parkinson's disease

2013 ◽  
Vol 332 (1-2) ◽  
pp. 136-140 ◽  
Author(s):  
Diego Santos-García ◽  
Raúl de la Fuente-Fernández
2011 ◽  
Vol 26 (3) ◽  
pp. 399-406 ◽  
Author(s):  
Pablo Martinez-Martin ◽  
Carmen Rodriguez-Blazquez ◽  
Monica M. Kurtis ◽  
K. Ray Chaudhuri ◽  

2015 ◽  
Vol 86 (11) ◽  
pp. e4.80-e4
Author(s):  
Fahd Baig ◽  
Michael Lawton ◽  
Michal Rolinski ◽  
Claudio Ruffmann ◽  
Kannan Nithi ◽  
...  

ObjectiveTo delineate treatment and quality of life of non-motor symptoms (NMS) in early Parkinson's disease (PD) and first-degree relatives.BackgroundNon-motor symptoms (NMS) are an important prodromal feature of Parkinson's disease (PD). However, their frequency, treatment rates and impact on health-related quality of life (HRQoL) in the early motor phase is unclear.Methods769 population-ascertained PD subjects within 3.5 years of diagnosis and 287 control subjects were assessed. Validated severity questionnaires were employed to assess NMS symptoms across the following domains: (1) neuropsychiatric (2) gastrointestinal (3) sleep (4) sensory (5) autonomic (6) sexual. Health related quality of life (HRQoL), functional status and management were also evaluated.ResultsNMS were common in early PD. More than half of the PD cases had hyposmia, pain, fatigue, sleep disturbance or urinary dysfunction. PD cases had worse HRQoL scores than controls (OR 4.1, p<0.001) with depression, anxiety and pain being stronger drivers than MDS-UPDRS motor scores. Quality of life is affected in early PD, although 23% of participants reported no problems. NMS were rarely treated in routine clinical practice.ConclusionsDespite their major impact on HRQoL, NMS are usually under-recognised and treated. The use of screening tools could improve recognition and treatment of NMS in early PD.


2020 ◽  
Author(s):  
Sabine Schootemeijer ◽  
Nicolien M. van der Kolk ◽  
Bastiaan R. Bloem ◽  
Nienke M. de Vries

Abstract Parkinson’s disease (PD) is a progressive neurological disorder characterized by motor and non-motor symptoms for which only symptomatic treatments exist. Exercise is a widely studied complementary treatment option. Aerobic exercise, defined as continuous movement of the body’s large muscles in a rhythmic manner for a sustained period that increases caloric requirements and aims at maintaining or improving physical fitness, appears promising. We performed both a scoping review and a systematic review on the generic and disease-specific health benefits of aerobic exercise for people with PD. We support this by a meta-analysis on the effects on physical fitness (VO2max), motor symptoms (Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor section), and health-related quality of life (39-item Parkinson’s disease Questionnaire (PDQ-39)). Aerobic exercise has generic health benefits for people with PD, including a reduced incidence of cardiovascular disease, a lower mortality, and an improved bone health. Additionally, there is level 1 evidence that aerobic exercise improves physical fitness (VO2max) and attenuates motor symptoms (MDS-UPDRS motor section) in the off-medication state, although the long-term effects (beyond 6 months) remain unclear. Dosing the exercise matters: improvements appear to be greater after training at higher intensities compared with moderate intensities. We found insufficient evidence for a beneficial effect of aerobic exercise on health-related quality of life (PDQ-39) and conflicting results regarding non-motor symptoms. Compliance to exercise regimes is challenging for PD patients but may be improved by adding exergaming elements to the training program. Aerobic exercise seems a safe intervention for people with PD, although care must be taken to avoid falls in at-risk individuals. Further studies are needed to establish the long term of aerobic exercise, including a focus on non-motor symptoms and health-related quality of life.


2020 ◽  
Author(s):  
Xiaojing Fan ◽  
Yaxin Zhao ◽  
Huanyuan Luo ◽  
Ben James ◽  
Duolao Wang ◽  
...  

Abstract Background This study aims to explore the association between the total number of non-motor symptoms and the Parkinson’s disease (PD) patients’ health-related quality of life quantitatively, using data from one of the largest smartphone-powered studies and a simplified version of 8-item Parkinson’s disease Quality of life Questionnaire (PDQ-8). Methods The data used for analysis constitutes one part of a dataset derived from the project named ‘100 for Parkinson’s’, an initiative of uMotif in conjunction with the Cure Parkinson’s Trust, Parkinson’s UK and the European Parkinson’s Disease Association. 1246 patients were included in the baseline survey. The 30-item Non-Motor Symptom (NMS-30) Questionnaire and PDQ-8 Summary Index (PDQ-8 SI) were used to measure health-related quality of life and a generalized linear model was used to analyze the association of the non-motor symptoms and quality of life. Results The mean number of NMS per patient was 11.81 ± 5.53. For patients with limited ability to work: the key symptoms were urgency (77.4%), sad or blue (71.05%) and difficulty getting to sleep or staying asleep (70.90%). After controlling for the life-style determinants and psychological symptoms prior PD diagnosis determinants, GLM presented the total sum of NMS-30 questions had the strongest positive influence on health-related quality of life as measured by the PDQ-8 SI. Where the sum of NMS scores increases by 1 point, the PDQ-8 SI will increase by 1.33 points (95%CI: 1.13, 1.52; P < 0.001). For patients without limited ability to work: urgency (62.45%), difficulty getting to sleep or staying asleep (59.81%) and getting up regularly at night to pass urine (55.09%) were the most frequent symptoms. GLM showed that where the total sum of NMS scores increases by 1 point, the PDQ-8 SI will increase by 1.56 points (95%CI: 1.37, 1.76; P < 0.001) after controlling for other confounders. Conclusions This smartphone-based study finds a higher total number of non-motor symptoms is related to a lower health-related quality of life for PD patients. It provides useful evidence for the PDQ-8 instrument and is helpful for a multidisciplinary approach to patient care and facilitate the provision of more comprehensive education for patients and caregivers.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Michaela Karlstedt ◽  
Seyed-Mohammad Fereshtehnejad ◽  
Dag Aarsland ◽  
Johan Lökk

The relationship quality, mutuality, has been identified as a protective factor in family care situations, but its role in mediating health-related quality of life (HRQoL) in patients having Parkinson’s disease (PD) is not known. Data on patients’ and partners’ mutuality (MS), motor signs (UPDRS III), non-motor symptoms (NMSQuest), impaired cognition (IQCODE), dependency in activities of daily life (ADL), and HRQoL (PDQ8) were collected from 51 dyads. Structural equation model with manifest variables was applied to explore if the MS score mediated the effect of UPDRS III, NMSQuest, IQCODE, and dependency in ADL on PDQ8. The results suggest that increasing severity of motor and non-motor symptoms decreases patients’ mutuality which leads to worse HRQoL. Partners’ mutuality mediated the effect of impaired cognition which in turn decreased patients’ mutuality. The findings enhance our understanding of how various symptoms may influence PD patients’ HRQoL. This may help clinicians to personalize interventions to provide more effective interventions to improve the lives of patients with PD.


2020 ◽  
Author(s):  
Xiaojing Fan ◽  
Yaxin Zhao ◽  
Huanyuan Luo ◽  
Ben James ◽  
Duolao Wang ◽  
...  

Abstract Background This study aims to explore the association between the total number of non-motor symptoms and the Parkinson’s disease (PD) patients’ health-related quality of life quantitatively, using data from one of the largest smartphone-powered studies and a simplified version of 8-item Parkinson’s disease Quality of life Questionnaire (PDQ-8). Methods The data used for analysis constitutes one part of a dataset derived from the project named ‘100 for Parkinson’s’. 1246 patients were included in the baseline survey. The 30-item Non-Motor Symptom (NMS-30) Questionnaire and PDQ-8 Summary Index (PDQ-8 SI) were used to measure health-related quality of life and a generalized linear model was used to analyze the association of the non-motor symptoms and quality of life. Results The mean number of NMS per patient was 11.81 ± 5.53. For patients with limited ability to work: the key symptoms were urgency (77.4%), sad or blue (71.05%) and difficulty getting to sleep or staying asleep (70.90%). After controlling for the life-style determinants and psychological symptoms prior PD diagnosis determinants, GLM presented the total sum of NMS-30 questions had the strongest positive influence on health-related quality of life as measured by the PDQ-8 SI. Where the sum of NMS scores increases by 1 point, the PDQ-8 SI will increase by 1.33 points (95%CI: 1.13, 1.52; P < 0.001). For patients without limited ability to work: urgency (62.45%), difficulty getting to sleep or staying asleep (59.81%) and getting up regularly at night to pass urine (55.09%) were the most frequent symptoms. GLM showed that where the total sum of NMS scores increases by 1 point, the PDQ-8 SI will increase by 1.56 points (95%CI: 1.37, 1.76; P < 0.001) after controlling for other confounders. Conclusions This smartphone-based study finds a higher total number of non-motor symptoms is related to a lower health-related quality of life for PD patients. It provides useful evidence for the PDQ-8 instrument and is helpful for a multidisciplinary approach to patient care and facilitate the provision of more comprehensive education for patients and caregivers.


2021 ◽  
pp. 1-15
Author(s):  
Eduardo Tolosa ◽  
Georg Ebersbach ◽  
Joaquim J. Ferreira ◽  
Olivier Rascol ◽  
Angelo Antonini ◽  
...  

Background: A greater understanding of the everyday experiences of people with Parkinson’s disease (PD) and their carers may help improve clinical practice. Objective: The Parkinson’s Real-world Impact assesSMent (PRISM) study evaluated medication use, health-related quality of life (HRQoL) and the use of healthcare resources by people with PD and their carers. Methods: PRISM is an observational cross-sectional study, in which people with PD and their carers completed an online survey using structured questionnaires, including the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQuest) and Zarit Burden Interview (ZBI). Results: Data were collected from 861 people with PD (mean age, 65.0 years; mean disease duration, 7.7 years) and 256 carers from six European countries. People with PD reported a large number of different co-morbidities, non-motor symptoms (mean NMSQuest score, 12.8), and impaired HRQoL (median PDQ-39 summary score, 29.1). Forty-five percent of people with PD reported at least one impulse control behaviour. Treatment patterns varied considerably between different European countries. Levodopa was taken in the last 12 months by 85.9% of participants, and as monotherapy by 21.8% . Carers, who were mostly female (64.8%) and the partner/spouse of the person with PD (82.1%), reported mild to moderate burden (mean ZBI total score, 26.6). Conclusions: The PRISM study sheds light on the lives of people with PD and those who care for them, re-emphasising the many challenges they face in everyday life. The study also provides insights into the current treatment of PD in Europe.


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