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The impact of motor and non-motor symptoms upon health-related quality of life in early Parkinson's disease: the incidence of cognitive impairment in cohorts with longitudinal evaluation: Parkinson's Disease (ICICLE-PD) Study

Lookup NU author(s): Dr Gordon Duncan, Dr Tien Khoo, Professor Alison Yarnall, Professor John O'Brien, Professor David Burn


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Abstract Introduction: Non-motor symptoms (NMSs) are common in patients with established Parkinson's disease (PD). We aimed to determine the frequency and impact of NMS upon health-related quality-of-life (HRQoL) in early PD. Methods: Patients with newly diagnosed PD attending neurology and geriatric medicine clinics in Newcastle and Gateshead were invited to participate. NMSs were assessed with the Non-Motor Symptom Questionnaire. HRQoL was measured with the Parkinson's Disease Quality of Life Questionnaire (PDQ-39). Additional assessments included: Movement Disorders Society revised Unified Parkinson's Disease Rating Scale part 3 (MDS-UPDRS-3); Geriatric Depression Scale-15; Mini-mental State Examination, Montreal Cognitive Assessment; Epworth Sleep Scale and Pittsburgh Sleep Quality Index. Results: A total of 158 PD patients and 99 controls participated. The mean age of the PD patients was 66.5 ± 10.3 years, 105 (66.5%) were male, and disease duration was 6.3 ± 5.9 months. There were no differences in age, gender or education level between groups. PD patients reported more NMSs than controls (mean total = 8.4 ± 4.3 versus 2.8 ± 2.5, P < 0.001). Hypersalivation (56%), urinary urgency (47%), hyposmia (45%), anxiety (43.8%) and constipation (42%) were most frequent. Patients with tremor-dominant disease reported fewer NMS than patients with non-tremor-dominant disease (6.3 versus 9.3, P < 0.001). Patients reported poorest HRQoL in PDQ-39 domains assessing bodily discomfort, mobility and activities of daily living (ADL). There was a significant correlation between total NMS reported and PDQ-39 score (P < 0.001). Depression (P < 0.001) and anxiety (P < 0.001) had greatest negative impact upon PDQ-39. Greater motor disability predicted higher PDQ-39 scores (P < 0.001). Patients with non-tremor-dominant disease reported reduced HRQoL in mobility (P < 0.001), ADL (P = 0.036) and bodily discomfort (P = 0.044) compared with tremor-dominant patients. Conclusion: Motor and NMSs have a negative impact upon HRQoL in patients with early PD. NMS, particularly anxiety and depression are common and should not be ignored by clinicians caring for those with early PD.

Publication metadata

Author(s): Khoo TK; O'Brien JT; Burn DJ; Yarnall AJ; Duncan GW; Barker RA

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: British Geriatrics Society Spring Meeting

Year of Conference: 2013

Pages: iii25-iii25

ISSN: 0002-0729 (Print) 1468-2834 (Online)

Publisher: Oxford University Press


DOI: 10.1093/ageing/aft106

Series Title: Age and Ageing