The Key Determinants to Quality of Life in Parkinson's Disease Patients: Results from the Parkinson's Disease Biomarker Program (PDBP).
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SUBMITTER: He L
PROVIDER: S-EPMC5729889 | biostudies-literature | 2016 May
REPOSITORIES: biostudies-literature
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The Key Determinants to Quality of Life in Parkinson's Disease Patients: Results from the Parkinson's Disease Biomarker Program (PDBP).
He Lu L Lee Eun-Young EY Sterling Nicholas W NW Kong Lan L Lewis Mechelle M MM Du Guangwei G Eslinger Paul J PJ Huang Xuemei X
Journal of Parkinson's disease 20160501 3
<h4>Background</h4>The impact of motor- and non-motor symptoms on health-related quality of life (HRQOL) in Parkinson's disease (PD) has received increasing attention.<h4>Objectives</h4>To address this, the study explored a large cohort of patients enrolled in the PD Biomarker Program.<h4>Methods</h4>The PD Questionnaire-39 (PDQ-39) measured HRQOL, whereas the Unified PD Rating Scale (UPDRS) assessed motor and non-motor symptoms. Determinants of HRQOL in PD patients were identified by stepwise l ...[more]
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Project description:ObjectivesHealth-related quality of life (HRQoL) is considered a very important outcome indicator in patients with Parkinson's disease (PD). A broad list of motor and non-motor features have been shown to affect HRQoL in PD, however, there is a dearth of information about the complexity of interrelationships between determinants of HRQoL in different PD phenotypes. We aimed to find independent determinates and the best structural model for HRQoL, also to investigate the heterogeneity in HRQoL between PD patients with different phenotypes regarding onset-age, progression rate and dominant symptom.MethodsA broad spectrum of demographic, motor and non-motor characteristics were collected in 157 idiopathic PD patients, namely comorbidity profile, nutritional status, UPDRS (total items), psychiatric symptoms (depression, anxiety), fatigue and psychosocial functioning through physical examination, validated questionnaires and scales. Structural equation model (SEM) and multivariate regressions were applied to find determinants of Parkinson's disease summary index (PDSI) and different domains of HRQoL (PDQ-39).ResultsFemale sex, anxiety, depression and UPDRS-part II scores were the significant independent determinants of PDSI. A structural model consisting of global motor, global non-motor and co-morbidity indicator as three main components was able to predict 89% of the variance in HRQoL. In older-onset and slow-progression phenotypes, the motor domain showed smaller contribution on HRQoL and the majority of its effects were mediated through non-motor features. Comorbidity component was a significant determinant of HRQoL only among older-onset and non-tremor-dominant PD patients. Fatigue was not a significant indicator of non-motor component to affect HRQoL in rapid-progression PD.ConclusionsOur findings showed outstanding heterogeneities in the pattern and determinants of HRQoL among PD phenotypes. These factors should be considered during the assessments and developing personalized interventions to improve HRQOL in PD patients with different phenotypes or prominent feature.
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