J Neurol Neurosurg Psychiatry 2000;69:308-312 ( September )

What contributes to quality of life in patients with Parkinson's disease?

Anette Schrag, Marjan Jahanshahi, Niall Quinn

Department of Neurology, Institute of Neurology, Queen Square, London WC1N 3BG, UK

Correspondence to: Professor NP Quinn n.quinn{at}ion.ucl.ac.uk

Received 2 September 1999 and in revised form 10 February 2000; Accepted 24 February 2000

OBJECTIVETo 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.
METHODSAll 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.
RESULTSThe 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.
CONCLUSIONDepression, 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.


Keywords: quality of life; Parkinson's disease

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© 2000 by Journal of Neurology, Neurosurgery, and Psychiatry
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What contributes to quality of life in patients with Parkinson's disease?

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