What contributes to quality of life in patients with Parkinson's disease?

TLDR

Quality of life is increasingly recognised as a critical health measure that reflects patients’ own perspective. The study aims to identify factors determining quality of life in idiopathic Parkinson’s disease patients in a population‑based sample. Participants completed the PDQ‑39 and Beck Depression Inventory and underwent a structured interview and neurological examination (Hoehn‑Yahr, Schwab‑England, UPDRS part III, MMSE). Depression, disability, postural instability, and cognitive impairment were the strongest predictors of poorer quality of life, with akinetic‑rigid patients scoring worse than tremor‑dominant patients; these factors should be prioritized in treatment.

Abstract

<h3>OBJECTIVE</h3> To identify the factors that determine quality of life (QoL) in patients with idiopathic Parkinson9s disease in a population based sample. Quality of life (QoL) is increasingly recognised as a critical measure in health care as it incorporates the patients9 own perspective of their health. <h3>METHODS</h3> All patients with Parkinson9s disease seen in a population based study on the prevalence of parkinsonism were asked to complete a disease-specific QoL questionnaire (PDQ-39) and the Beck depression inventory. A structured questionnaire interview and a complete neurological examination, including the Hoehn and Yahr scale, the Schwab and England disability scale, the motor part of the unified Parkinson9s disease rating scale (UPDRS part III), and the mini mental state examination were performed by a neurologist on the same day. <h3>RESULTS</h3> The response rate was 78%. The factor most closely associated with QoL was the presence of depression, but disability, as measured by the Schwab and England scale, postural instability, and cognitive impairment additionally contributed to poor QoL. Although the UPDRS part III correlated significantly with QoL scores, it did not contribute substantially to predicting their variance once depression, disability, and postural instability had been taken into account. In addition, patients with akinetic rigid Parkinson9s disease had worse QoL scores than those with tremor dominant disease, mainly due to impairment of axial features. <h3>CONCLUSION</h3> Depression, disability, postural instability, and cognitive impairment have the greatest influence on QoL in Parkinson9s disease. The improvement of these features should therefore become an important target in the treatment of the disease.