title: [Impact of motor and non-motor symptoms on the direct costs of Parkinson's disease].
abstract: BACKGROUND
  We evaluate the health-related economic burden of patients with Parkinson's disease (PD) and identify the impact of motor and nonmotor symptoms (NMS) and health-related quality of life (HRQL) on the direct costs of PD in Spain.
  
  
  METHODS
  A cross-sectional, multicenter, pilot study covering consecutive PD outpatients who were included during the year 2004. Cognition (MMSE, SCOPA-Cog), autonomic dysfunction (SCOPA-AUT), motor impairment, severity and complications (SCOPA-motor), depression/anxiety (HADS), sleep (PDSS), psychosis (PPRS), pain, severity/global impairment (HY staging and CISI-PD) and health-related quality of life (EuroQoL) were evaluated. PD-related cost data were obtained using a standardized questionnaire. Association of clinical variables with direct costs was analyzed using the parametric and nonparametric tests.
  
  
  RESULTS
  Seventy-eight consecutive PD outpatients (52% female and 48% male) having a mean age of 68.2 years (SD: 11), median HY stage of 2 (1-5), and mean PD duration of 8.3 years (SD: 5.4) were included in this study. Average 3 month total direct cost of PD was euro 2,631 (SD: 4507) per person (range: euro 71.5-euro 29,159) and medical treatment was the main cost driver, accounting for 34 % (mean drug cost per person euro 669; SD: 406). PD direct costs were significantly higher among younger patients, with higher HY stage, PD duration, severity, motor impairment and motor complications (p<0.05).
  
  
  CONCLUSIONS
  Disease severity, motor impairment and complications had a higher impact on the direct costs of PD than NMS.
authors.affiliation: Departamento de Epidemiologia Aplicada, Instituto de Salud Carlos III, Madrid. esthercub@wanadoo.es
authors.forename: E
authors.initials: E
authors.lastname: Cubo
authors.forename: P
authors.initials: P
authors.lastname: Martínez Martin
authors.forename: M
authors.initials: M
authors.lastname: González
authors.forename: B
authors.initials: B
authors.lastname: Frades
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000191:economics / Q000503:physiopathology; D010865:Pilot Projects; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires