title: Lifestyle regularity measured by the social rhythm metric in Parkinson's disease.
abstract: Parkinson's disease (PD) is a chronic progressive motor disorder that may present with a spectrum of symptoms and disease severity. Therapy is frequently associated with motor fluctuations and dyskinesias; therefore, monitoring of motor fluctuations and daily abilities is important for adequate management. The Social Rhythm Metric (SRM) is a diary-like questionnaire that quantifies the extent to which a person's life is regular vs. irregular on a daily basis with respect to event timing. Lifestyle regularity has been assessed by the SRM in other clinical situations. The aim of this study was to evaluate lifestyle regularity in a population with PD using the SRM and its relationship to clinical and therapeutic factors. Twenty-eight consecutive patients with PD and 14 control subjects were studied. Severity of motor dysfunction was evaluated with the Unified Parkinson's Disease Rating Scale (UPDRS). Depressive symptoms were assessed with the Montgomery Asberg Depressive Rating Scale (MADRS), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and subjective daytime sleepiness with the Epworth sleepiness scale. Daily lifestyle regularity was assessed by the SRM for 2 weeks. Patients with PD had lower SRM scores than controls, and those with motor fluctuations had even lower scores (p=0.04). Patients with motor fluctuations showed more clinical disability (p=0.01), a worse quality of sleep (p=0.02), and more depressive symptoms (p=0.02). SRM results were correlated with PSQI values (p=0.016). Our findings show that the regularity of daily activities as measured by the SRM is disorganized in patients with PD and that this irregularity is related to sleep quality.
authors.affiliation: Department of Medicine, Universidade Federal do Ceará, Ceará, Brazil.
authors.forename: Samir
authors.initials: S
authors.lastname: Câmara Magalhães
authors.forename: Carlos
authors.initials: C
authors.lastname: Vitorino Souza
authors.forename: Tiago
authors.initials: T
authors.lastname: Rocha Dias
authors.forename: Pedro
authors.initials: P
authors.lastname: Felipe Carvalhedo de Bruin
authors.forename: Veralice Meireles Sales
authors.initials: VM
authors.lastname: de Bruin
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003863:Depression / Q000150:complications / Q000503:physiopathology; D006233:Persons with Disabilities; D005260:Female; D006184:Habits; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D017440:Photoperiod; D012890:Sleep / Q000502:physiology; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014851:Wakefulness / Q000502:physiology