Predictors and course of health‐related quality of life in Parkinson's disease
Identifieur interne : 003258 ( Main/Merge ); précédent : 003257; suivant : 003259Predictors and course of health‐related quality of life in Parkinson's disease
Auteurs : Elin Bjelland Forsaa [Norvège] ; Jan Petter Larsen [Norvège] ; Tore Wentzel-Larsen [Norvège] ; Karen Herlofson [Norvège] ; Guido Alves [Norvège]Source :
- Movement Disorders [ 0885-3185 ] ; 2008-07-30.
Descripteurs français
- Wicri :
- geographic : Norvège.
English descriptors
- KwdEn :
- Activities of Daily Living, Aged, Aged, 80 and over, Cognition Disorders (etiology), Cognition Disorders (psychology), Depression (etiology), Depression (psychology), Disabled Persons (psychology), Disease Progression, Female, Follow-Up Studies, Hallucinations (etiology), Hallucinations (psychology), Humans, Male, Middle Aged, Norway (epidemiology), Parkinson Disease (complications), Parkinson Disease (psychology), Parkinson's disease, Prognosis, Prospective Studies, Quality of Life, Questionnaires, Severity of Illness Index, Single-Blind Method, Sleep Disorders, Intrinsic (etiology), Sleep Disorders, Intrinsic (psychology), Social Isolation, cohort study, longitudinal, prospective, quality of life.
- MESH :
- geographic , epidemiology : Norway.
- complications : Parkinson Disease.
- etiology : Cognition Disorders, Depression, Hallucinations, Sleep Disorders, Intrinsic.
- psychology : Cognition Disorders, Depression, Disabled Persons, Hallucinations, Parkinson Disease, Sleep Disorders, Intrinsic.
- Activities of Daily Living, Aged, Aged, 80 and over, Disease Progression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Quality of Life, Questionnaires, Severity of Illness Index, Single-Blind Method, Social Isolation.
Abstract
We investigated how health related quality of life (HRQL) changes over time in a population‐based cohort of patients with Parkinson's disease (PD), and which factors predict a lower level of HRQL in these patients. Of 227 patients with PD assessed at baseline and followed prospectively, information on HRQL‐status was obtained in 111 subjects 4 years and 82 patients 8 years after inclusion. HRQL was measured by the Nottingham Health Profile (NHP). Analyses were conducted using generalized estimating equation models. The NHP total score (P < 0.001) and scores in all NHP dimensions except for sleep worsened significantly during follow‐up. Steepest slope was found for the domain physical mobility (3.16, 95% CI 2.39–3.92), followed by the domains social isolation (2.22, 95% CI 1.52–2.93) and emotional reactions (1.36, 95% CI 0.74–1.97). In addition to follow‐up time, higher Hoehn and Yahr staging, higher Montgomery and Aasberg Depression Rating Scale scores, and presence of insomnia at baseline were associated with lower levels of overall HRQL during follow‐up. We conclude that PD has an increasing impact on HRQL as the disease progresses. During long‐term follow‐up, deterioration in physical mobility was the most important single factor contributing to decline in HRQL in our cohort, although distress of nonmotor character as a whole outweighed the impact of distress in physical mobility on overall HRQL. More advanced disease, higher severity of depressive symptoms, and presence of insomnia were found to be important and independent predictors of poor HRQL. © 2008 Movement Disorder Society
Url:
DOI: 10.1002/mds.22121
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<front><div type="abstract" xml:lang="en">We investigated how health related quality of life (HRQL) changes over time in a population‐based cohort of patients with Parkinson's disease (PD), and which factors predict a lower level of HRQL in these patients. Of 227 patients with PD assessed at baseline and followed prospectively, information on HRQL‐status was obtained in 111 subjects 4 years and 82 patients 8 years after inclusion. HRQL was measured by the Nottingham Health Profile (NHP). Analyses were conducted using generalized estimating equation models. The NHP total score (P < 0.001) and scores in all NHP dimensions except for sleep worsened significantly during follow‐up. Steepest slope was found for the domain physical mobility (3.16, 95% CI 2.39–3.92), followed by the domains social isolation (2.22, 95% CI 1.52–2.93) and emotional reactions (1.36, 95% CI 0.74–1.97). In addition to follow‐up time, higher Hoehn and Yahr staging, higher Montgomery and Aasberg Depression Rating Scale scores, and presence of insomnia at baseline were associated with lower levels of overall HRQL during follow‐up. We conclude that PD has an increasing impact on HRQL as the disease progresses. During long‐term follow‐up, deterioration in physical mobility was the most important single factor contributing to decline in HRQL in our cohort, although distress of nonmotor character as a whole outweighed the impact of distress in physical mobility on overall HRQL. More advanced disease, higher severity of depressive symptoms, and presence of insomnia were found to be important and independent predictors of poor HRQL. © 2008 Movement Disorder Society</div>
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<front><div type="abstract" xml:lang="en">We investigated how health related quality of life (HRQL) changes over time in a population‐based cohort of patients with Parkinson's disease (PD), and which factors predict a lower level of HRQL in these patients. Of 227 patients with PD assessed at baseline and followed prospectively, information on HRQL‐status was obtained in 111 subjects 4 years and 82 patients 8 years after inclusion. HRQL was measured by the Nottingham Health Profile (NHP). Analyses were conducted using generalized estimating equation models. The NHP total score (P < 0.001) and scores in all NHP dimensions except for sleep worsened significantly during follow‐up. Steepest slope was found for the domain physical mobility (3.16, 95% CI 2.39–3.92), followed by the domains social isolation (2.22, 95% CI 1.52–2.93) and emotional reactions (1.36, 95% CI 0.74–1.97). In addition to follow‐up time, higher Hoehn and Yahr staging, higher Montgomery and Aasberg Depression Rating Scale scores, and presence of insomnia at baseline were associated with lower levels of overall HRQL during follow‐up. We conclude that PD has an increasing impact on HRQL as the disease progresses. During long‐term follow‐up, deterioration in physical mobility was the most important single factor contributing to decline in HRQL in our cohort, although distress of nonmotor character as a whole outweighed the impact of distress in physical mobility on overall HRQL. More advanced disease, higher severity of depressive symptoms, and presence of insomnia were found to be important and independent predictors of poor HRQL. © 2008 Movement Disorder Society</div>
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<affiliation wicri:level="1"><nlm:affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway. bjellandforsaa@gmail.com</nlm:affiliation>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger</wicri:regionArea>
<wicri:noRegion>Stavanger</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Larsen, Jan Petter" sort="Larsen, Jan Petter" uniqKey="Larsen J" first="Jan Petter" last="Larsen">Jan Petter Larsen</name>
</author>
<author><name sortKey="Wentzel Larsen, Tore" sort="Wentzel Larsen, Tore" uniqKey="Wentzel Larsen T" first="Tore" last="Wentzel-Larsen">Tore Wentzel-Larsen</name>
</author>
<author><name sortKey="Herlofson, Karen" sort="Herlofson, Karen" uniqKey="Herlofson K" first="Karen" last="Herlofson">Karen Herlofson</name>
</author>
<author><name sortKey="Alves, Guido" sort="Alves, Guido" uniqKey="Alves G" first="Guido" last="Alves">Guido Alves</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="2008" type="published">2008</date>
</imprint>
</series>
</biblStruct>
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</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cognition Disorders (etiology)</term>
<term>Cognition Disorders (psychology)</term>
<term>Depression (etiology)</term>
<term>Depression (psychology)</term>
<term>Disabled Persons (psychology)</term>
<term>Disease Progression</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Hallucinations (etiology)</term>
<term>Hallucinations (psychology)</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Norway (epidemiology)</term>
<term>Parkinson Disease (complications)</term>
<term>Parkinson Disease (psychology)</term>
<term>Prognosis</term>
<term>Prospective Studies</term>
<term>Quality of Life</term>
<term>Questionnaires</term>
<term>Severity of Illness Index</term>
<term>Single-Blind Method</term>
<term>Sleep Disorders, Intrinsic (etiology)</term>
<term>Sleep Disorders, Intrinsic (psychology)</term>
<term>Social Isolation</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Norway</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cognition Disorders</term>
<term>Depression</term>
<term>Hallucinations</term>
<term>Sleep Disorders, Intrinsic</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Cognition Disorders</term>
<term>Depression</term>
<term>Disabled Persons</term>
<term>Hallucinations</term>
<term>Parkinson Disease</term>
<term>Sleep Disorders, Intrinsic</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Disease Progression</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prognosis</term>
<term>Prospective Studies</term>
<term>Quality of Life</term>
<term>Questionnaires</term>
<term>Severity of Illness Index</term>
<term>Single-Blind Method</term>
<term>Social Isolation</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Norvège</term>
</keywords>
</textClass>
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<front><div type="abstract" xml:lang="en">We investigated how health related quality of life (HRQL) changes over time in a population-based cohort of patients with Parkinson's disease (PD), and which factors predict a lower level of HRQL in these patients. Of 227 patients with PD assessed at baseline and followed prospectively, information on HRQL-status was obtained in 111 subjects 4 years and 82 patients 8 years after inclusion. HRQL was measured by the Nottingham Health Profile (NHP). Analyses were conducted using generalized estimating equation models. The NHP total score (P < 0.001) and scores in all NHP dimensions except for sleep worsened significantly during follow-up. Steepest slope was found for the domain physical mobility (3.16, 95% CI 2.39-3.92), followed by the domains social isolation (2.22, 95% CI 1.52-2.93) and emotional reactions (1.36, 95% CI 0.74-1.97). In addition to follow-up time, higher Hoehn and Yahr staging, higher Montgomery and Aasberg Depression Rating Scale scores, and presence of insomnia at baseline were associated with lower levels of overall HRQL during follow-up. We conclude that PD has an increasing impact on HRQL as the disease progresses. During long-term follow-up, deterioration in physical mobility was the most important single factor contributing to decline in HRQL in our cohort, although distress of nonmotor character as a whole outweighed the impact of distress in physical mobility on overall HRQL. More advanced disease, higher severity of depressive symptoms, and presence of insomnia were found to be important and independent predictors of poor HRQL. (c) 2008 Movement Disorder Society.</div>
</front>
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