scholarly journals Impact of age at onset on symptom profiles, treatment characteristics and health-related quality of life in Parkinson’s disease

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Lars Lau Raket ◽  
Daniel Oudin Åström ◽  
Jenny M. Norlin ◽  
Klas Kellerborg ◽  
Pablo Martinez-Martin ◽  
...  

AbstractParkinson’s disease (PD) is typically considered an age-related disease, but the age at disease onset can vary by decades between patients. Aging and aging-associated diseases can affect the movement system independently of PD, and advanced age has previously been proposed to be associated with a more severe PD phenotype with accelerated progression. In this work, we investigated how interactions between PD progression and aging affect a wide range of outcomes related to PD motor and nonmotor symptoms as well as Health Related Quality of Life (HRQoL) and treatment characteristics. This population-based cohort study is based on 1436 PD patients from southern Sweden followed longitudinally for up to approximately 7.5 years from enrollment (3470 visits covering 2285 patient years, average follow-up time 1.7 years). Higher age at onset was generally associated with faster progression of motor symptoms, with a notable exception of dyskinesia and other levodopa-associated motor fluctuations that had less severe trajectories for patients with higher age at onset. Mixed results were observed for emergence of non-motor symptoms, while higher age at onset was generally associated with worse HRQoL trajectories. Accounting for these identified age-associated differences in disease progression could positively impact patient management and drug development efforts.

2021 ◽  
Author(s):  
Per Odin ◽  
Jenny Norlin ◽  
Klas Kellerborg ◽  
Lars Raket ◽  
Pablo Martinez-Martin ◽  
...  

Abstract Parkinson’s disease (PD) is typically considered an age-related disease, but the age at disease onset can vary by decades between patients. Aging and aging-associated diseases can affect the movement system independently of PD, and advanced age has previously been proposed to be associated with a more severe PD phenotype with accelerated progression. In this work, we investigated how interactions between PD progression and aging affect a wide range of outcomes related to PD motor and nonmotor symptoms as well as Health Related Quality of Life (HRQoL) and treatment characteristics. This population-based cohort study is based on 1436 PD patients from southern Sweden followed longitudinally for up to approximately 7.5 years from enrollment. Higher age at onset was generally associated with faster progression of motor symptoms, with a notable exception of dyskinesia and other levodopa-associated motor fluctuations that had less severe trajectories for patients with higher age at onset. Mixed results were observed for emergence of non-motor symptoms, while higher age at onset was generally associated with worse HRQoL trajectories. Accounting for these identified age-associated differences in disease progression could positively impact patient management and drug development efforts.


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.


2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
M. Klietz ◽  
T. Schnur ◽  
S. Drexel ◽  
F. Lange ◽  
A. Tulke ◽  
...  

Parkinson’s disease (PD) is a chronic progressive movement disorder with severe reduction in patients’ health-related quality of life (HR-QoL). Motor and cognitive symptoms are especially linked with decreased PD patients’ HR-QoL. However, the relationship of these symptoms to caregiver burden is relatively unclear. Influence of the Montreal Cognitive Assessment scale (MoCA) as a cognitive screening tool and Movement Disorders Society Unified Parkinson’s disease Rating Scale MDS-UPDRS symptoms in relation to patients’ HR-QoL and caregivers` burden was analyzed. PD patients (n = 124) completed MDS-UPDRS, MoCA, and the PD questionnaire 8 (PDQ-8) as a measure of quality of life. Caregivers (n = 78) were assessed by the PD caregiver burden inventory (PDCB). PDQ-8 and PDCB scores were regressed on MDS-UPDRS subscales and MoCA subscores. PDQ-8 correlated with attention (R2 0.1282; p<0.001) and executive (R2 0.0882; p 0.001) MoCA subscores and all parts of the MDS-UPDRS. PDCB correlated most strongly with MDS-UPDRS part III motor symptoms (R2 0.2070; p<0.001) and the MoCA attention subscore (R2 0.1815; p<0.001). While all facets of PD symptoms assessed by the MDS-UPDRS relate to PD patients’ quality of life, motor symptoms are the most relevant factor for the prediction of caregiver burden. In addition, patients’ attentional symptoms seem to affect not only them, but also their caregivers. These findings show the potential of a detailed analysis of MDS-UPDRS and MoCA performance in PD patients.


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.


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