Weight loss and impact on quality of life in Parkinson's disease.
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ABSTRACT:
SUBMITTER: Akbar U
PROVIDER: S-EPMC4418600 | biostudies-other | 2015
REPOSITORIES: biostudies-other
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Project description:BackgroundThe quality of life (QoL) of informal caregivers of people with Parkinson's disease (PD) (PwP) can be affected by the caring role. Because of cognitive symptoms and diminished activities of daily living, in addition to the management of motor symptoms, carers of PwP and cognitive impairment may experience increased levels of burden and poorer QoL compared with carers of PwP without cognitive impairment. This study aimed to investigate the impact of cognitive impairment in PD upon QoL of carers.MethodsApproximately 36 months after diagnosis, 66 dyadic couples of PwP and carers completed assessments. PwP completed a schedule of neuropsychological assessments and QoL measures; carers of PwP completed demographic questionnaires and assessments of QoL. Factor scores of attention, memory/executive function and global cognition, as derived by principal component analysis, were used to evaluate cognitive domains.ResultsHierarchical regression analysis found lower Montreal Cognitive Assessment was a significant independent predictor of poorer carer QoL, in addition to number of hours spent caregiving, carer depression and PD motor severity. Attentional deficits accounted for the largest proportion of variance of carer QoL. Carers of PwP and dementia (n = 9) had significantly poorer QoL scores compared with PwP and mild cognitive impairment (n = 18) or normal cognition (n = 39) carers (p < 0.01).ConclusionsAttentional deficits were the strongest predictor of carer QoL compared with other cognitive predictors. Carers for those with PD dementia reported the poorest QoL. Interventions such as respite or cognitive behavioural therapy to improve mood and self-efficacy in carers may improve carer QoL. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.
| S-EPMC5724657 | biostudies-literature
Project description:This study investigated changes in the quality of life of men and women who participated in a primary care-based weight loss intervention program.Participants were enrolled in a 2-year randomized clinical trial (POWER-UP) conducted at the University of Pennsylvania and in six affiliated primary care practices. Inclusion criteria included the presence of obesity (body mass index of 30-50 kg m(-2)) and at least two components of the metabolic syndrome.Quality of life was assessed by three measures: the Short Form Health Survey (SF-12); the Impact of Weight on Quality of Life-Lite; and the EuroQol-5D.Six months after the onset of treatment, and with a mean weight loss of 3.9 ± 0.3 kg, participants reported significant improvements on all measures of interest with the exception of the Mental Component Score of the SF-12. These changes remained significantly improved from baseline to month 24, with the exception of the EuroQol-5D. Many of these improvements were correlated with the magnitude of weight loss and, for the most part, were consistent across gender and ethnic group.Individuals with obesity and components of the metabolic syndrome reported significant improvements in most domains of the quality of life with a modest weight loss of 3.7% of initial weight, which was achieved within the first 6 months of treatment. The majority of these improvements were maintained at month 24, when participants had lost 3.0% of their weight.
| S-EPMC3786773 | biostudies-literature
Project description:Obese dogs have been shown to have a diminished quality of life; however, there is less evidence characterizing the impact of obesity on the quality of life of cats. A cross-sectional survey study was conducted among cat owners with either healthy weight cats (body condition scores of 4-5/9) or obese cats (body condition scores of 8-9/9) as determined by a veterinarian. Exclusion criteria included medical conditions (determined by physical exam and screening bloodwork). Cat owners completed surveys on quality of life and perceptions of feline obesity. Quality of life scores for obese cats had a wider range and were numerically lower compared to scores of healthy weight cats with a moderate effect size of 0.68, though this was not a statistically significant difference (71.2 ± 8.8 vs. 75.9 ± 4.1, p = 0.0881; n = 33). Owners of obese cats less frequently reported that obesity was a high risk to their cat's health (77% [10/13]) vs. 100% [20/20]) and less frequently cited the primary caretaker as a cause of cat obesity (30% [3/10] vs. 55% [11/20]) compared to the owners of healthy weight cats. Interestingly, 97% (32/33) of all owners believed veterinarians should play a role in feline weight loss. These results suggest that some obese cats can have a potentially diminished quality of life but highlights the need for more data surrounding the impact of feline obesity and enhanced client communication strategies to best address obesity in the feline population.
| S-EPMC7924056 | biostudies-literature
Project description:PurposeThis study aimed to determine predictors of health-related quality of life (HRQoL) in Parkinson's disease (PD) and to explore their predictive value before and after controlling overlapping items between HRQoL and clinical variables.MethodsOne hundred and eight PD patients underwent motor, anxiety, depression, apathy, fatigue, and neurocognition assessment. HRQoL was assessed by the Parkinson's Disease Questionnaire-39 (PDQ-39). In order to determine predictors of HRQoL in PD, stepwise multiple regression analyses were performed in two ways: before and after removing the emotional well-being dimension from PDQ-39 to control the overlap between depression and anxiety, and HRQoL.ResultsHRQoL total index was predicted by anxiety, fatigue, motor symptoms, and depression, explaining 26.9%, 7.2%, 2.8%, and 1.9% of the variance. However, after removing overlapping items, HRQoL total index was predicted by fatigue (16.5%), anxiety (6.1%), motor symptoms (3.9%), and neurocognition (2.5%), but not depression. Regarding HRQoL dimensions, mobility and activities of daily living were predicted by fatigue (19.7% and 5%) and UPDRS-III (4% and 10.2%); emotional well-being by fatigue (7.9%); social support by anxiety (12.2%) and UPDRS-III (8.6%); communication by neurocognition (5.3%) and UPDRS-III (3.4%); cognition by anxiety (10.6%) and bodily discomfort by anxiety (23%) and fatigue (4.1%).ConclusionThese findings showed the importance of identifying and controlling overlapping items of HRQoL and clinical measures to perform an accurate interpretation. HRQoL dimensions showed different predictors before and after controlling the overlap. Based on these results fatigue, anxiety, motor symptoms, and neurocognition, but not depression are the main predictors of HRQoL in PD patients.
| S-EPMC9546987 | biostudies-literature
Project description:Research has shown a negative relationship between weight bias internalization (WBI) and general measures of health-related quality of life (QOL), such as the Short Form-36. Less is known about the impact of WBI on weight-specific domains of QOL. This study examined the relationship between WBI and weight-related QOL, as measured by the Impact of Weight on Quality of Life (IWQOL-Lite) scale. Participants were 178 adults with obesity [71.3% black, 87.6% female, mean body mass index (BMI) = 40.9 ± 5.9 kg/m2] enrolled in a weight loss trial testing the effects of lorcaserin on weight loss maintenance. At baseline, participants completed the Weight Bias Internalization Scale (WBIS), the IWQOL-Lite and the Patient Health Questionnaire (PHQ-9, to assess symptoms of depression). Total scores for the IWQOL-Lite and its five subscales (Physical Function, Self-Esteem, Sexual Life, Public Distress and Work) were calculated. Linear regression analyses showed that WBIS scores were associated with the IWQOL-Lite total score and all subscales above and beyond the effects of demographic variables, BMI, and depressive symptoms (beta values = -0.18 to -0.70, p values < 0.019). The relationship between WBIS and the IWQOL-Lite scales did not differ by gender or race. WBI was associated with mental and physical aspects of weight-related QOL in a predominantly black and female treatment-seeking sample of patients with obesity. Prioritizing the development of interventions to reduce WBI may be important for improving weight-related QOL.
| S-EPMC6304379 | biostudies-literature
Project description:Background: Early morning off (EMO) refers to off-states in the morning in people diagnosed with Parkinson's disease (PwPD). This study determined the clinical manifestations of EMO and the association with nocturnal sleep problems and quality of life (QOL) in Chinese PwPD. Methods: In this multicenter, observational, cross-sectional study, data concerning the clinical manifestations of EMO were collected from PwPD in Shanghai by questionnaire. The stepwise logistic regression was performed to analyze the potential risk factors, as well as whether EMO was an independent risk factor for functional dependency in daily life. The mediation analyses were conducted to evaluate whether nocturnal sleep problems might mediate the association between EMO and the QOL. Results: Among the 454 subjects evaluated, EMO occurred in 39.43% of PwPD across all disease stages. The prevalence of EMO increased as the Hoehn and Yahr stage increased and was observed in 35.60% of patients in stages 1-2.5 and 48.85% of patients in stages 3-5. EMO was associated with non-motor symptoms (NMSs). The predominant NMSs associated with EMO were nocturnal sleep problems (98.90%), mood/cognition impairment (93.90%), decreased attention/memory (91.60%), gastrointestinal symptoms (91.60%), and urinary urgency (90.50%). The QOL of PwPD with EMO was significantly reduced (P < 0.001). Moreover, nocturnal sleep problems might partially mediate this relationship (indirect effect: β = 13.458, 95% boot CI: 6.436, 22.042). Conclusion: PwPD have EMO throughout all stages of the disease. Patients with EMO have severe motor symptoms and NMSs. EMO decreases the QOL in PwPD and this relationship is partially mediated by nocturnal sleep problems. In light of these findings, it is suggested that recognition and appropriate treatment of EMO and nocturnal sleep problems could improve the management of PwPD.
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Project description:The clinical presentation of Parkinson's disease (PD) is often dominated by depressive symptoms, which can significantly impact the patients' quality of life (QoL). However, it is not clear how these depressive symptoms are interconnected, or if some symptoms are more influential in affecting QoL. In the Cohort of Patients with Parkinson's Disease in Spain (COPPADIS) study, 686 patients with PD were analyzed using network analyses. The patients completed the Beck Depression Inventory II (BDI-II) and provided their overall QoL (EUROHIS-QOL) at the beginning of the study. The study used centrality measures such as Expected Influence and Bridge Expected Influence to identify depressive symptoms that had the greatest impact on overall QoL. The results of exploratory network analyses indicate that the BDI-II items related to loss of energy, past failure, and tiredness or fatigue have the greatest impact on overall QoL as measured by the EUROHIS-QOL 8-item index. The loss of energy and tiredness or fatigue BDI-II items are also strongly associated with a number of different EUROHIS-QOL items, according to Bridge Expected Influences. For individuals suffering from PD, network analysis can aid in identifying significant non-motor symptoms that impact their QoL, thus paving the way for potential improvements.
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Project description:In Parkinson's disease, pain is a prevalent and complex symptom of diverse origin. King's Parkinson's disease pain scale, assesses different pain syndromes, thus allowing exploration of its differential prevalence and influence on the health-related quality of life of patients. Post hoc study 178 patients and 83 matched controls participating in the King's Parkinson's disease pain scale validation study were used. For determining the respective distribution, King's Parkinson's disease pain scale items and domains scores?=?0 meant absence and ?1 presence of the symptom. The regular scores were used for the other analyses. Health-related quality of lifewas evaluated with EQ-5D-3L and PDQ-8 questionnaires. Parkinson's disease patients experienced more pain modalities than controls. In patients, Pain around joints (King's Parkinson's disease pain scale item 1) and Pain while turning in bed (item 8) were the most prevalent types of pain, whereas Burning mouth syndrome (item 11) and Pain due to grinding teeth (item 10) showed the lowest frequency. The total number of experienced pain modalities closely correlated with the PDQ-8 index, but not with other variables. For all pain types except Pain around joints (item 1) and pain related to Periodic leg movements/RLS (item 7), patients with pain had significantly worse health-related quality of life. The influence of pain, as a whole, on the health-related quality of life was not remarkable after adjustment by other variables. When the particular types of pain were considered, adjusted by sex, age, and Parkinson's disease duration, pain determinants were different for EQ-5D-3L and PDQ-8. King's Parkinson's disease pain scale allows exploring the distribution of the diverse syndromic pain occurring in Parkinson's disease and its association with health-related quality of life.
| S-EPMC5459857 | biostudies-other
Project description:Aim: The aim of the study was to investigate the effect of the onset of Parkinson's disease (PD) on life satisfaction. Method: Data from 2008, 2011, and 2014 were used from a population-based prospective cohort (German Ageing Survey; 8,982 observations in FE regression analysis) of community-residing individuals in the second half of life (?40 years) in Germany. Satisfaction with life was quantified using the established Satisfaction with Life Scale. Physician-diagnosed PD was reported. Results: In total, 48.9% were female. The mean age was 63.8 years (±11.3 years). Average life satisfaction equaled 3.8 (±0.7). Linear fixed effects regressions revealed that the onset of PD was associated with a considerable decline in life satisfaction (? = -0.37, 95% CI -0.69 to -0.05, p < 0.05). This effect was significantly more pronounced in men. Moreover, a decrease in life satisfaction was associated with younger age, changes from "employed" to "not employed," worsening self-rated health, the onset of depression, and an increase in the number of physical illnesses. Conclusions: The onset of PD is associated with a marked reduction of life satisfaction among individuals in the second half of life in the total sample and in men, but not in women. For example, this effect was about twice as large as the effect of depression on life satisfaction. Moreover, the effect of PD on life satisfaction was more pronounced than the effect of a strong decrease in self-rated health (from "very good" to "very bad") on life satisfaction. Effective treatment of symptoms might contribute to maintaining life satisfaction.
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Project description:Type 2 diabetes mellitus (T2DM) and obesity constitute interwoven pandemics challenging healthcare systems in developed countries, where diabetic kidney disease (DKD) is the most common cause of end-stage renal disease. Obesity accelerates renal functional decline in people with T2DM. Intentional weight loss (IWL) strategies in this population hold promise as a means of arresting DKD progression. In the present paper, we summarize the impact of IWL strategies (stratified by lifestyle intervention, medications, and metabolic surgery) on renal outcomes in obese people with DKD. We reviewed the Medline, EMBASE and Cochrane databases for relevant randomized control trials and observational studies published between August 1, 2018 and April 15, 2019. We found that IWL improves renal outcomes in the setting of DKD and obesity. Rate of progression of DKD slows with IWL, but varying outcome measures among studies makes direct comparison difficult. Furthermore, established means of estimating renal function are imperfect owing to loss of lean muscle mass with IWL strategies. The choice of optimal IWL strategy needs to be individualized; future work should establish the comparative efficacy of IWL strategies in obese people with DKD to better inform such decisions.
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