Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1999 Apr;66(4):431–435. doi: 10.1136/jnnp.66.4.431

Influence of clinical and demographic variables on quality of life in patients with Parkinson's disease

K H Karlsen 1, J Larsen 1, E Tandberg 1, J Maland 1
PMCID: PMC1736304  PMID: 10201412

Abstract

OBJECTIVES—To identify the clinical and demographic factors that are associated with a poor quality of life in patients with Parkinson's disease.
METHODS—233 of a total of 245 patients identified in a community based study in a Norwegian county participated in the study. Quality of life was measured by the Nottingham Health Profile (NHP). The results were compared with those in 100 healthy elderly people. Clinical and demographic variables were determined during a semistructured interview and by clinical examination by a neurologist. Multiple regression analyses were used to determine which variables were associated with higher distress scores.
RESULTS—Patients with Parkinson's disease had higher distress scores than the healthy elderly people for all the NHP dimensions. The variables that most strongly predicted a high total NHP score were depressive symptoms, self reported insomnia, and a low degree of independence, measured by the Schwab and England scale. Severity of parkinsonism contributed, but to a lesser extent. Nearly half the patients with Parkinson's disease reported lack of energy, compared with a fifth of the control group. Severity of depressive symptoms and a higher score on the UPDRS motor subscale only partly accounted for this finding. Only 30% of the variation in NHP energy score was explained by the predictive variables identified in this study.
CONCLUSIONS—Parkinson's disease has a substantial impact on health related quality of life. Depressive symptoms and sleep disorders correlated strongly with high distress scores. Patients with Parkinson's disease should be examined for both conditions, which require treatment. Low energy was commonly reported and may be a separate entity of Parkinson's disease.



Full Text

The Full Text of this article is available as a PDF (96.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bergner M., Bobbitt R. A., Carter W. B., Gilson B. S. The Sickness Impact Profile: development and final revision of a health status measure. Med Care. 1981 Aug;19(8):787–805. doi: 10.1097/00005650-198108000-00001. [DOI] [PubMed] [Google Scholar]
  2. Block G., Liss C., Reines S., Irr J., Nibbelink D. Comparison of immediate-release and controlled release carbidopa/levodopa in Parkinson's disease. A multicenter 5-year study. The CR First Study Group. Eur Neurol. 1997;37(1):23–27. doi: 10.1159/000117399. [DOI] [PubMed] [Google Scholar]
  3. Cummings J. L. Depression and Parkinson's disease: a review. Am J Psychiatry. 1992 Apr;149(4):443–454. doi: 10.1176/ajp.149.4.443. [DOI] [PubMed] [Google Scholar]
  4. Dornan T. L., Peck G. M., Dow J. D., Tattersall R. B. A community survey of diabetes in the elderly. Diabet Med. 1992 Nov;9(9):860–865. doi: 10.1111/j.1464-5491.1992.tb01906.x. [DOI] [PubMed] [Google Scholar]
  5. Essink-Bot M. L., van Royen L., Krabbe P., Bonsel G. J., Rutten F. F. The impact of migraine on health status. Headache. 1995 Apr;35(4):200–206. doi: 10.1111/j.1526-4610.1995.hed3504200.x. [DOI] [PubMed] [Google Scholar]
  6. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  7. Friedman J., Friedman H. Fatigue in Parkinson's disease. Neurology. 1993 Oct;43(10):2016–2018. doi: 10.1212/wnl.43.10.2016. [DOI] [PubMed] [Google Scholar]
  8. Henderson L., Kennard C., Crawford T. J., Day S., Everitt B. S., Goodrich S., Jones F., Park D. M. Scales for rating motor impairment in Parkinson's disease: studies of reliability and convergent validity. J Neurol Neurosurg Psychiatry. 1991 Jan;54(1):18–24. doi: 10.1136/jnnp.54.1.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hoehn M. M., Yahr M. D. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17(5):427–442. doi: 10.1212/wnl.17.5.427. [DOI] [PubMed] [Google Scholar]
  10. Hunt S. M., McEwen J., McKenna S. P. Measuring health status: a new tool for clinicians and epidemiologists. J R Coll Gen Pract. 1985 Apr;35(273):185–188. [PMC free article] [PubMed] [Google Scholar]
  11. Hunt S. M., McKenna S. P., McEwen J., Williams J., Papp E. The Nottingham Health Profile: subjective health status and medical consultations. Soc Sci Med A. 1981 May;15(3 Pt 1):221–229. doi: 10.1016/0271-7123(81)90005-5. [DOI] [PubMed] [Google Scholar]
  12. Jenkinson C., Fitzpatrick R., Argyle M. The Nottingham Health Profile: an analysis of its sensitivity in differentiating illness groups. Soc Sci Med. 1988;27(12):1411–1414. doi: 10.1016/0277-9536(88)90207-9. [DOI] [PubMed] [Google Scholar]
  13. Jenkinson C., Peto V., Fitzpatrick R., Greenhall R., Hyman N. Self-reported functioning and well-being in patients with Parkinson's disease: comparison of the short-form health survey (SF-36) and the Parkinson's Disease Questionnaire (PDQ-39) Age Ageing. 1995 Nov;24(6):505–509. doi: 10.1093/ageing/24.6.505. [DOI] [PubMed] [Google Scholar]
  14. Larsen J. P., Dupont E., Tandberg E. Clinical diagnosis of Parkinson's disease. Proposal of diagnostic subgroups classified at different levels of confidence. Acta Neurol Scand. 1994 Apr;89(4):242–251. doi: 10.1111/j.1600-0404.1994.tb01674.x. [DOI] [PubMed] [Google Scholar]
  15. Lees A. J., Blackburn N. A., Campbell V. L. The nighttime problems of Parkinson's disease. Clin Neuropharmacol. 1988 Dec;11(6):512–519. doi: 10.1097/00002826-198812000-00004. [DOI] [PubMed] [Google Scholar]
  16. Longstreth W. T., Jr, Nelson L., Linde M., Muñoz D. Utility of the sickness impact profile in Parkinson's disease. J Geriatr Psychiatry Neurol. 1992 Jul-Sep;5(3):142–148. doi: 10.1177/002383099200500303. [DOI] [PubMed] [Google Scholar]
  17. Mutch W. J., Strudwick A., Roy S. K., Downie A. W. Parkinson's disease: disability, review, and management. Br Med J (Clin Res Ed) 1986 Sep 13;293(6548):675–677. doi: 10.1136/bmj.293.6548.675. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Nausieda P. A., Weiner W. J., Kaplan L. R., Weber S., Klawans H. L. Sleep disruption in the course of chronic levodopa therapy: an early feature of the levodopa psychosis. Clin Neuropharmacol. 1982;5(2):183–194. doi: 10.1097/00002826-198205020-00003. [DOI] [PubMed] [Google Scholar]
  19. Peto V., Jenkinson C., Fitzpatrick R., Greenhall R. The development and validation of a short measure of functioning and well being for individuals with Parkinson's disease. Qual Life Res. 1995 Jun;4(3):241–248. doi: 10.1007/BF02260863. [DOI] [PubMed] [Google Scholar]
  20. Tandberg E., Larsen J. P., Aarsland D., Cummings J. L. The occurrence of depression in Parkinson's disease. A community-based study. Arch Neurol. 1996 Feb;53(2):175–179. doi: 10.1001/archneur.1996.00550020087019. [DOI] [PubMed] [Google Scholar]
  21. Tandberg E., Larsen J. P., Nessler E. G., Riise T., Aarli J. A. The epidemiology of Parkinson's disease in the county of Rogaland, Norway. Mov Disord. 1995 Sep;10(5):541–549. doi: 10.1002/mds.870100503. [DOI] [PubMed] [Google Scholar]
  22. de Boer A. G., Wijker W., Speelman J. D., de Haes J. C. Quality of life in patients with Parkinson's disease: development of a questionnaire. J Neurol Neurosurg Psychiatry. 1996 Jul;61(1):70–74. doi: 10.1136/jnnp.61.1.70. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES