What contributes to quality of life in patients with Parkinson's disease?
What contributes to quality of life in patients with Parkinson's disease?
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DOI：
10.1136/jnnp.69.3.308
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发表时间：
2000-09-01
影响因子：
11
通讯作者：
Quinn, N
中科院分区：
文献类型：
--
作者：
Schrag, A;Jahanshahi, M;Quinn, N
目的-在基于人群的样本中确定决定特发性帕金森病患者生活质量 (QoL) 的因素。生活质量 (QoL) 越来越被认为是医疗保健中的一项关键指标，因为它纳入了患者对自身健康的看法。 方法 - 在一项关于帕金森病患病率的人群研究中发现的所有帕金森病患者均被要求填写疾病特异性 QoL 问卷 (PDQ-39) 和贝克抑郁量表。当天由神经科医生进行了结构化问卷访谈和完整的神经系统检查，包括Hoehn和Yahr量表、Schwab和England残疾量表、统一帕金森病评定量表的运动部分（UPDRS第III部分）以及简易精神状态检查。 结果——有效率78%。与生活质量最密切相关的因素是抑郁症的存在，但通过施瓦布和英格兰量表衡量的残疾、姿势不稳定和认知障碍也会导致生活质量不佳。尽管 UPDRS 第三部分与生活质量评分显着相关，但一旦考虑到抑郁、残疾和姿势不稳，它对预测其方差没有太大贡献。此外，运动不能性强直性帕金森病患者的生活质量评分比震颤主导型帕金森病患者差，这主要是由于轴性特征受损所致。结论——抑郁、残疾、姿势不稳和认知障碍对帕金森病患者的生活质量影响最大。因此，改善这些特征应该成为治疗该疾病的重要目标。
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.