Health-related quality of life in early Parkinson's disease: The impact of nonmotor symptoms
Health-related quality of life in early Parkinson's disease: The impact of nonmotor symptoms
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DOI：
10.1002/mds.25664
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发表时间：
2014-02-01
影响因子：
8.6
通讯作者：
Burn, David J.
中科院分区：
文献类型：
--
作者：
Duncan, Gordon W.;Khoo, Tien K.;Burn, David J.
非运动症状（NMS）在帕金森病（PD）患者中很常见，对生活质量有重大影响。我们调查了NMS与新诊断PD患者健康相关生活质量（HRQoL）的关系。招募患者和健康对照作为帕金森病研究中队列中认知障碍发生率纵向评估的一部分。NMS的患病率采用非运动症状问卷调查。采用帕金森病生活质量问卷（PDQ-39）记录HRQoL。进一步的评估包括运动障碍、抑郁、睡眠和认知的测量。158例新诊断的PD患者和99例对照患者参加了这项横断面研究。患者报告的NMS数量多于对照组（平均8.3 +/- 4.3 vs 2.8 +/- 2.5症状; P < 0.001）。患者在评估身体不适、活动能力和日常生活活动方面报告的HRQoL最低。运动和非运动症状对HRQoL评分有负面影响。与震颤显性疾病患者相比，姿势不稳定和步态困难运动亚型患者的HRQoL更差。抑郁（P < 0.001）、肠排空不全（P < 0.001）、焦虑（P < 0.001）、注意力不集中（P <0.001）、记忆力不佳（P < 0.001）和失眠（P = 0.001）对HRQoL的负面影响最大。NMS在早期PD患者中很常见，是健康相关生活质量较差的重要原因。认知、神经精神和睡眠障碍与幸福感降低特别相关。这些症状的筛查和管理应在诊断时优先考虑。(c)2013年国际帕金森和运动障碍协会
Nonmotor symptoms (NMS) are common in patients with established Parkinson's disease (PD) and have a major impact upon quality of life. We investigated the significance of NMS in relation to health-related quality of life (HRQoL) in patients with newly diagnosed PD. Patients and healthy controls were recruited as part of the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in Parkinson's Disease Study. Prevalence of NMS was determined with the Non-Motor Symptom Questionnaire. HRQoL was recorded with the 39-item Parkinson's Disease Quality of Life Questionnaire (PDQ-39). Further assessments included measures of motor disability, depression, sleep, and cognition. One hundred and fifty-eight patients with newly diagnosed PD and 99 controls participated in this cross-sectional study. Patients reported greater numbers of NMS than controls (mean 8.3 +/- 4.3 versus 2.8 +/- 2.5 symptoms; P < 0.001). Patients reported lowest HRQoL in the domains assessing bodily discomfort, mobility, and activities of daily living. Motor and nonmotor symptoms impacted negatively upon HRQoL scores. Patients with the postural instability and gait difficulty motor subtype reported worse HRQoL, compared with those with tremor-dominant disease. Depression (P < 0.001), incomplete bowel emptying (P < 0.001), anxiety (P < 0.001), impaired concentration (P < 0.001), memory complaints (P < 0.001), and insomnia (P = 0.001) had the greatest negative impact upon HRQoL. NMS are common in patients with early PD and represent a significant cause of poorer health-related quality of life. Cognitive, neuropsychiatric, and sleep disturbances are particularly associated with reduced well-being. Screening and management of these symptoms should be prioritized at the time of diagnosis. (c) 2013 International Parkinson and Movement Disorder Society