title: What contributes to quality of life in patients with Parkinson's disease?
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology, Institute of Neurology, Queen Square, London WC1N 3BG, UK.
authors.forename: A
authors.initials: A
authors.lastname: Schrag
authors.forename: M
authors.initials: M
authors.lastname: Jahanshahi
authors.forename: N
authors.initials: N
authors.lastname: Quinn
mesh_terms: D000368:Aged; D003072:Cognition Disorders; D003866:Depressive Disorder / Q000209:etiology; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D011187:Posture; D011788:Quality of Life; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires