Predictors and course of health‐related quality of life in Parkinson's disease
Identifieur interne : 001436 ( Main/Corpus ); précédent : 001435; suivant : 001437Predictors and course of health‐related quality of life in Parkinson's disease
Auteurs : Elin Bjelland Forsaa ; Jan Petter Larsen ; Tore Wentzel-Larsen ; Karen Herlofson ; Guido AlvesSource :
- Movement Disorders [ 0885-3185 ] ; 2008-07-30.
English descriptors
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
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DOI: 10.1002/mds.22121
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Predictors and course of health‐related quality of life in Parkinson's disease</title><author><name sortKey="Forsaa, Elin Bjelland" sort="Forsaa, Elin Bjelland" uniqKey="Forsaa E" first="Elin Bjelland" last="Forsaa">Elin Bjelland Forsaa</name><affiliation><mods:affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation></author><author><name sortKey="Larsen, Jan Petter" sort="Larsen, Jan Petter" uniqKey="Larsen J" first="Jan Petter" last="Larsen">Jan Petter Larsen</name><affiliation><mods:affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation></author><author><name sortKey="Wentzel Arsen, Tore" sort="Wentzel Arsen, Tore" uniqKey="Wentzel Arsen T" first="Tore" last="Wentzel-Larsen">Tore Wentzel-Larsen</name><affiliation><mods:affiliation>Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway</mods:affiliation></affiliation></author><author><name sortKey="Herlofson, Karen" sort="Herlofson, Karen" uniqKey="Herlofson K" first="Karen" last="Herlofson">Karen Herlofson</name><affiliation><mods:affiliation>Department of Neurology, Sorlandet Hospital, Arendal, Norway</mods:affiliation></affiliation></author><author><name sortKey="Alves, Guido" sort="Alves, Guido" uniqKey="Alves G" first="Guido" last="Alves">Guido Alves</name><affiliation><mods:affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:A8824CEF3F64DE1F5BA4D468EA203699CBDF256D</idno><date when="2008" year="2008">2008</date><idno type="doi">10.1002/mds.22121</idno><idno type="url">https://api.istex.fr/document/A8824CEF3F64DE1F5BA4D468EA203699CBDF256D/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">001436</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Predictors and course of health‐related quality of life in Parkinson's disease</title><author><name sortKey="Forsaa, Elin Bjelland" sort="Forsaa, Elin Bjelland" uniqKey="Forsaa E" first="Elin Bjelland" last="Forsaa">Elin Bjelland Forsaa</name><affiliation><mods:affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation></author><author><name sortKey="Larsen, Jan Petter" sort="Larsen, Jan Petter" uniqKey="Larsen J" first="Jan Petter" last="Larsen">Jan Petter Larsen</name><affiliation><mods:affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation></author><author><name sortKey="Wentzel Arsen, Tore" sort="Wentzel Arsen, Tore" uniqKey="Wentzel Arsen T" first="Tore" last="Wentzel-Larsen">Tore Wentzel-Larsen</name><affiliation><mods:affiliation>Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway</mods:affiliation></affiliation></author><author><name sortKey="Herlofson, Karen" sort="Herlofson, Karen" uniqKey="Herlofson K" first="Karen" last="Herlofson">Karen Herlofson</name><affiliation><mods:affiliation>Department of Neurology, Sorlandet Hospital, Arendal, Norway</mods:affiliation></affiliation></author><author><name sortKey="Alves, Guido" sort="Alves, Guido" uniqKey="Alves G" first="Guido" last="Alves">Guido Alves</name><affiliation><mods:affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2008-07-30">2008-07-30</date><biblScope unit="volume">23</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1420">1420</biblScope><biblScope unit="page" to="1427">1427</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">A8824CEF3F64DE1F5BA4D468EA203699CBDF256D</idno><idno type="DOI">10.1002/mds.22121</idno><idno type="ArticleID">MDS22121</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>cohort study</term><term>longitudinal</term><term>prospective</term><term>quality of life</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><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></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Elin Bjelland Forsaa MD</name><affiliations><json:string>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</json:string><json:string>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</json:string></affiliations></json:item><json:item><name>Jan Petter Larsen PhD</name><affiliations><json:string>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</json:string><json:string>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</json:string></affiliations></json:item><json:item><name>Tore Wentzel‐Larsen MSc</name><affiliations><json:string>Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway</json:string></affiliations></json:item><json:item><name>Karen Herlofson PhD</name><affiliations><json:string>Department of Neurology, Sorlandet Hospital, Arendal, Norway</json:string></affiliations></json:item><json:item><name>Guido Alves PhD</name><affiliations><json:string>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</json:string><json:string>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>quality of life</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>prospective</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>longitudinal</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cohort study</value></json:item></subject><articleId><json:string>MDS22121</json:string></articleId><language><json:string>eng</json:string></language><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</abstract><qualityIndicators><score>7.537</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1611</abstractCharCount><pdfWordCount>4597</pdfWordCount><pdfCharCount>30517</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>245</abstractWordCount></qualityIndicators><title>Predictors and course of health‐related quality of life in Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>23</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>8</total><last>1427</last><first>1420</first></pages><issn><json:string>0885-3185</json:string></issn><issue>10</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2008</publicationDate><copyrightDate>2008</copyrightDate><doi><json:string>10.1002/mds.22121</json:string></doi><id>A8824CEF3F64DE1F5BA4D468EA203699CBDF256D</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/A8824CEF3F64DE1F5BA4D468EA203699CBDF256D/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/A8824CEF3F64DE1F5BA4D468EA203699CBDF256D/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/A8824CEF3F64DE1F5BA4D468EA203699CBDF256D/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Predictors and course of health‐related quality of life in Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2008</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Predictors and course of health‐related quality of life in Parkinson's disease</title><author><persName><forename type="first">Elin Bjelland</forename><surname>Forsaa</surname></persName><roleName type="degree">MD</roleName><note type="correspondence"><p>Correspondence: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Box 8100, N‐4068 Stavanger, Norway</p></note><affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</affiliation><affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</affiliation></author><author><persName><forename type="first">Jan Petter</forename><surname>Larsen</surname></persName><roleName type="degree">PhD</roleName><affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</affiliation><affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</affiliation></author><author><persName><forename type="first">Tore</forename><surname>Wentzel‐Larsen</surname></persName><roleName type="degree">MSc</roleName><affiliation>Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway</affiliation></author><author><persName><forename type="first">Karen</forename><surname>Herlofson</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Neurology, Sorlandet Hospital, Arendal, Norway</affiliation></author><author><persName><forename type="first">Guido</forename><surname>Alves</surname></persName><roleName type="degree">PhD</roleName><affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</affiliation><affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2008-07-30"></date><biblScope unit="volume">23</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1420">1420</biblScope><biblScope unit="page" to="1427">1427</biblScope></imprint></monogr><idno type="istex">A8824CEF3F64DE1F5BA4D468EA203699CBDF256D</idno><idno type="DOI">10.1002/mds.22121</idno><idno type="ArticleID">MDS22121</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2008</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>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</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>quality of life</term></item><item><term>prospective</term></item><item><term>longitudinal</term></item><item><term>cohort study</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2007-10-31">Received</change><change when="2008-04-08">Registration</change><change when="2008-07-30">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/A8824CEF3F64DE1F5BA4D468EA203699CBDF256D/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. 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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 (<i>P</i> < 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</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Predictors and course of health‐related quality of life in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Quality of Life in Parkinson's Disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Predictors and course of health‐related quality of life in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Elin Bjelland</namePart><namePart type="family">Forsaa</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</affiliation><affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</affiliation><description>Correspondence: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Box 8100, N‐4068 Stavanger, Norway</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jan Petter</namePart><namePart type="family">Larsen</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</affiliation><affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Tore</namePart><namePart type="family">Wentzel‐Larsen</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karen</namePart><namePart type="family">Herlofson</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neurology, Sorlandet Hospital, Arendal, Norway</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Guido</namePart><namePart type="family">Alves</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway</affiliation><affiliation>Department of Neurology, Stavanger University Hospital, Stavanger, Norway</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2008-07-30</dateIssued><dateCaptured encoding="w3cdtf">2007-10-31</dateCaptured><dateValid encoding="w3cdtf">2008-04-08</dateValid><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">5</extent><extent unit="references">45</extent><extent unit="words">6636</extent></physicalDescription><abstract 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</abstract><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>quality of life</topic><topic>prospective</topic><topic>longitudinal</topic><topic>cohort study</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>23</number></detail><detail type="issue"><caption>no.</caption><number>10</number></detail><extent unit="pages"><start>1420</start><end>1427</end><total>8</total></extent></part></relatedItem><identifier type="istex">A8824CEF3F64DE1F5BA4D468EA203699CBDF256D</identifier><identifier type="DOI">10.1002/mds.22121</identifier><identifier type="ArticleID">MDS22121</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2008 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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