Nonmotor versus motor symptoms: how much do they matter to health status in Parkinson's disease?
Identifieur interne : 000C86 ( Main/Exploration ); précédent : 000C85; suivant : 000C87Nonmotor versus motor symptoms: how much do they matter to health status in Parkinson's disease?
Auteurs : Claire Hinnell [Royaume-Uni] ; Catherine S. Hurt ; Sabine Landau ; Richard G. Brown ; Michael SamuelSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2012.
English descriptors
- KwdEn :
- Adult, Age Factors, Aged, Aged, 80 and over, Anxiety (etiology), Cohort Studies, Depression (etiology), Disability Evaluation, Female, Health Status, Humans, Male, Middle Aged, Parkinson Disease (complications), Parkinson Disease (psychology), Quality of Life, Questionnaires, Regression Analysis, Severity of Illness Index.
- MESH :
- complications : Parkinson Disease.
- etiology : Anxiety, Depression.
- psychology : Parkinson Disease.
- Adult, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Disability Evaluation, Female, Health Status, Humans, Male, Middle Aged, Quality of Life, Questionnaires, Regression Analysis, Severity of Illness Index.
Abstract
Evidence suggests that both motor and nonmotor symptoms contribute to health status in Parkinson's disease. Less clear is how much change in health status can be expected if these clinical variables change. In addition, anxiety, separate from depression, has rarely been examined as a predictor of health status. We used hierarchical multiple regression analysis and standardized beta coefficients in a prevalent cohort of 462 patients with Parkinson's disease to explore the relative impact on health status (measured using the Parkinson's Disease Questionnaire) of 5 well-recognized symptom domains in Parkinson's disease: motor signs, depression, anxiety, cognition, and other nonmotor symptoms. In the health status scores, 19.6% of variance was explained by age, number of comorbidities, disease duration, and levodopa equivalent dose. Younger age predicted worse health status. A full regression model containing baseline variables and all 5 symptom domains explained 56% of the variance in health status. The standardized beta coefficient for depression was 2.1, 1.6, and 1.3 times that of motor signs, anxiety, and other nonmotor symptoms, respectively. Our findings provide a ranking order of clinical variables for their relative impact on health status in Parkinson's disease and show that depression has more than twice the impact of motor signs on health status. Anxiety and other nonmotor symptoms are also important separate determinants of poor health status in Parkinson's disease. Our results will help to guide the development of individual care and service planning for patients with Parkinson's disease.
DOI: 10.1002/mds.23961
PubMed: 21954027
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Nonmotor versus motor symptoms: how much do they matter to health status in Parkinson's disease?</title><author><name sortKey="Hinnell, Claire" sort="Hinnell, Claire" uniqKey="Hinnell C" first="Claire" last="Hinnell">Claire Hinnell</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, King's College Hospital, King's Health Partners, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, King's College Hospital, King's Health Partners, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Hurt, Catherine S" sort="Hurt, Catherine S" uniqKey="Hurt C" first="Catherine S" last="Hurt">Catherine S. Hurt</name></author><author><name sortKey="Landau, Sabine" sort="Landau, Sabine" uniqKey="Landau S" first="Sabine" last="Landau">Sabine Landau</name></author><author><name sortKey="Brown, Richard G" sort="Brown, Richard G" uniqKey="Brown R" first="Richard G" last="Brown">Richard G. Brown</name></author><author><name sortKey="Samuel, Michael" sort="Samuel, Michael" uniqKey="Samuel M" first="Michael" last="Samuel">Michael Samuel</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2012">2012</date><idno type="doi">10.1002/mds.23961</idno><idno type="RBID">pubmed:21954027</idno><idno type="pmid">21954027</idno><idno type="wicri:Area/PubMed/Corpus">001022</idno><idno type="wicri:Area/PubMed/Curation">001022</idno><idno type="wicri:Area/PubMed/Checkpoint">000D14</idno><idno type="wicri:Area/Ncbi/Merge">003408</idno><idno type="wicri:Area/Ncbi/Curation">003408</idno><idno type="wicri:Area/Ncbi/Checkpoint">003408</idno><idno type="wicri:Area/Main/Merge">000D04</idno><idno type="wicri:Area/Main/Curation">000C86</idno><idno type="wicri:Area/Main/Exploration">000C86</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Nonmotor versus motor symptoms: how much do they matter to health status in Parkinson's disease?</title><author><name sortKey="Hinnell, Claire" sort="Hinnell, Claire" uniqKey="Hinnell C" first="Claire" last="Hinnell">Claire Hinnell</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, King's College Hospital, King's Health Partners, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, King's College Hospital, King's Health Partners, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Hurt, Catherine S" sort="Hurt, Catherine S" uniqKey="Hurt C" first="Catherine S" last="Hurt">Catherine S. Hurt</name></author><author><name sortKey="Landau, Sabine" sort="Landau, Sabine" uniqKey="Landau S" first="Sabine" last="Landau">Sabine Landau</name></author><author><name sortKey="Brown, Richard G" sort="Brown, Richard G" uniqKey="Brown R" first="Richard G" last="Brown">Richard G. Brown</name></author><author><name sortKey="Samuel, Michael" sort="Samuel, Michael" uniqKey="Samuel M" first="Michael" last="Samuel">Michael Samuel</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Anxiety (etiology)</term><term>Cohort Studies</term><term>Depression (etiology)</term><term>Disability Evaluation</term><term>Female</term><term>Health Status</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (psychology)</term><term>Quality of Life</term><term>Questionnaires</term><term>Regression Analysis</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Anxiety</term><term>Depression</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Disability Evaluation</term><term>Female</term><term>Health Status</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Quality of Life</term><term>Questionnaires</term><term>Regression Analysis</term><term>Severity of Illness Index</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Evidence suggests that both motor and nonmotor symptoms contribute to health status in Parkinson's disease. Less clear is how much change in health status can be expected if these clinical variables change. In addition, anxiety, separate from depression, has rarely been examined as a predictor of health status. We used hierarchical multiple regression analysis and standardized beta coefficients in a prevalent cohort of 462 patients with Parkinson's disease to explore the relative impact on health status (measured using the Parkinson's Disease Questionnaire) of 5 well-recognized symptom domains in Parkinson's disease: motor signs, depression, anxiety, cognition, and other nonmotor symptoms. In the health status scores, 19.6% of variance was explained by age, number of comorbidities, disease duration, and levodopa equivalent dose. Younger age predicted worse health status. A full regression model containing baseline variables and all 5 symptom domains explained 56% of the variance in health status. The standardized beta coefficient for depression was 2.1, 1.6, and 1.3 times that of motor signs, anxiety, and other nonmotor symptoms, respectively. Our findings provide a ranking order of clinical variables for their relative impact on health status in Parkinson's disease and show that depression has more than twice the impact of motor signs on health status. Anxiety and other nonmotor symptoms are also important separate determinants of poor health status in Parkinson's disease. Our results will help to guide the development of individual care and service planning for patients with Parkinson's disease.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Brown, Richard G" sort="Brown, Richard G" uniqKey="Brown R" first="Richard G" last="Brown">Richard G. Brown</name><name sortKey="Hurt, Catherine S" sort="Hurt, Catherine S" uniqKey="Hurt C" first="Catherine S" last="Hurt">Catherine S. Hurt</name><name sortKey="Landau, Sabine" sort="Landau, Sabine" uniqKey="Landau S" first="Sabine" last="Landau">Sabine Landau</name><name sortKey="Samuel, Michael" sort="Samuel, Michael" uniqKey="Samuel M" first="Michael" last="Samuel">Michael Samuel</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Hinnell, Claire" sort="Hinnell, Claire" uniqKey="Hinnell C" first="Claire" last="Hinnell">Claire Hinnell</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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