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. 2000 Sep;69(3):308–312. doi: 10.1136/jnnp.69.3.308

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

A Schrag 1, M Jahanshahi 1, N Quinn 1
PMCID: PMC1737100  PMID: 10945804

Abstract

OBJECTIVE—To identify the factors that determine quality of life (QoL) in patients with idiopathic Parkinson's disease in a population based sample. Quality of life (QoL) is increasingly recognised as a critical measure in health care as it incorporates the patients' own perspective of their health.
METHODS—All patients with Parkinson's 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 Parkinson's disease rating scale (UPDRS part III), and the mini mental state examination were performed by a neurologist on the same day.
RESULTS—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 Parkinson's disease had worse QoL scores than those with tremor dominant disease, mainly due to impairment of axial features.
CONCLUSION—Depression, disability, postural instability, and cognitive impairment have the greatest influence on QoL in Parkinson's disease. The improvement of these features should therefore become an important target in the treatment of the disease.



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Selected References

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  1. BECK A. T., WARD C. H., MENDELSON M., MOCK J., ERBAUGH J. An inventory for measuring depression. Arch Gen Psychiatry. 1961 Jun;4:561–571. doi: 10.1001/archpsyc.1961.01710120031004. [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. Brazier J. E., Walters S. J., Nicholl J. P., Kohler B. Using the SF-36 and Euroqol on an elderly population. Qual Life Res. 1996 Apr;5(2):195–204. doi: 10.1007/BF00434741. [DOI] [PubMed] [Google Scholar]
  4. Fitzpatrick R., Jenkinson C., Peto V., Hyman N., Greenhall R. Desirable properties for instruments assessing quality of life: evidence from the PDQ-39. J Neurol Neurosurg Psychiatry. 1997 Jan;62(1):104–104. doi: 10.1136/jnnp.62.1.104. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fitzpatrick R., Peto V., Jenkinson C., Greenhall R., Hyman N. Health-related quality of life in Parkinson's disease: a study of outpatient clinic attenders. Mov Disord. 1997 Nov;12(6):916–922. doi: 10.1002/mds.870120613. [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. Gibb W. R., Lees A. J. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry. 1988 Jun;51(6):745–752. doi: 10.1136/jnnp.51.6.745. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Goetz C. G., Stebbins G. T. Risk factors for nursing home placement in advanced Parkinson's disease. Neurology. 1993 Nov;43(11):2227–2229. doi: 10.1212/wnl.43.11.2227. [DOI] [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. Jahanshahi M., Marsden C. D. Depression in torticollis: a controlled study. Psychol Med. 1988 Nov;18(4):925–933. doi: 10.1017/s0033291700009855. [DOI] [PubMed] [Google Scholar]
  11. Jankovic J., McDermott M., Carter J., Gauthier S., Goetz C., Golbe L., Huber S., Koller W., Olanow C., Shoulson I. Variable expression of Parkinson's disease: a base-line analysis of the DATATOP cohort. The Parkinson Study Group. Neurology. 1990 Oct;40(10):1529–1534. doi: 10.1212/wnl.40.10.1529. [DOI] [PubMed] [Google Scholar]
  12. Jenkinson C., Fitzpatrick R., Peto V., Greenhall R., Hyman N. The Parkinson's Disease Questionnaire (PDQ-39): development and validation of a Parkinson's disease summary index score. Age Ageing. 1997 Sep;26(5):353–357. doi: 10.1093/ageing/26.5.353. [DOI] [PubMed] [Google Scholar]
  13. Karlsen K. H., Larsen J. P., Tandberg E., Maeland J. G. Influence of clinical and demographic variables on quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 1999 Apr;66(4):431–435. doi: 10.1136/jnnp.66.4.431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. King R. B. Quality of life after stroke. Stroke. 1996 Sep;27(9):1467–1472. doi: 10.1161/01.str.27.9.1467. [DOI] [PubMed] [Google Scholar]
  15. Lang A. E., Lozano A. M. Parkinson's disease. Second of two parts. N Engl J Med. 1998 Oct 15;339(16):1130–1143. doi: 10.1056/NEJM199810153391607. [DOI] [PubMed] [Google Scholar]
  16. Livingston G., Watkin V., Milne B., Manela M. V., Katona C. The natural history of depression and the anxiety disorders in older people: the Islington community study. J Affect Disord. 1997 Dec;46(3):255–262. doi: 10.1016/s0165-0327(97)00155-9. [DOI] [PubMed] [Google Scholar]
  17. McHorney C. A., Ware J. E., Jr, Raczek A. E. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993 Mar;31(3):247–263. doi: 10.1097/00005650-199303000-00006. [DOI] [PubMed] [Google Scholar]
  18. 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]
  19. Peto V., Jenkinson C., Fitzpatrick R. PDQ-39: a review of the development, validation and application of a Parkinson's disease quality of life questionnaire and its associated measures. J Neurol. 1998 May;245 (Suppl 1):S10–S14. doi: 10.1007/pl00007730. [DOI] [PubMed] [Google Scholar]
  20. Richards M., Marder K., Cote L., Mayeux R. Reliability of symptom onset assessment in Parkinson's disease. Mov Disord. 1994 May;9(3):340–342. doi: 10.1002/mds.870090313. [DOI] [PubMed] [Google Scholar]
  21. Schrag A., Ben-Shlomo Y., Quinn N. P. Prevalence of progressive supranuclear palsy and multiple system atrophy: a cross-sectional study. Lancet. 1999 Nov 20;354(9192):1771–1775. doi: 10.1016/s0140-6736(99)04137-9. [DOI] [PubMed] [Google Scholar]
  22. Williams L. S., Weinberger M., Harris L. E., Biller J. Measuring quality of life in a way that is meaningful to stroke patients. Neurology. 1999 Nov 10;53(8):1839–1843. doi: 10.1212/wnl.53.8.1839. [DOI] [PubMed] [Google Scholar]
  23. Zetusky W. J., Jankovic J., Pirozzolo F. J. The heterogeneity of Parkinson's disease: clinical and prognostic implications. Neurology. 1985 Apr;35(4):522–526. doi: 10.1212/wnl.35.4.522. [DOI] [PubMed] [Google Scholar]

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[Correction to table 2]
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