title: Progression and prognostic factors of motor impairment, disability and quality of life in newly diagnosed Parkinson's disease.
abstract: OBJECTIVE
  To determine progression and prognostic factors of progression rate of motor impairment, disability, and quality of life (QoL) in patients with newly diagnosed Parkinson's disease.
  
  
  METHODS
  A group of 126 patients with newly diagnosed PD recruited from outpatient clinics participated in this 3-year prospective cohort study. Motor impairment was rated with the Unified Parkinson Disease Rating Scale Motor-Examination. Disability was rated using the Schwab and England Activities of Daily Living Scale, the AMC Linear Disability Score. QoL was assessed with the Parkinson's Disease Quality of Life questionnaire. Linear mixed model analyses were conducted to identify determinants of progression rate of motor impairment, disability, and poor QoL.
  
  
  RESULTS
  Motor impairment progressed with 3 points per year. There was a slight progression of disability and QoL during 3 years of follow-up. Female sex was a prognostic factor for slower progression of motor impairment and QoL. Older age at onset showed to prognosticate faster progression of disability and impaired QoL. Furthermore, independent of follow-up time, older age at onset was associated with worse motor impairment; nondopaminergic reactive symptoms (Axial impairment) were associated with more disability and poorer QoL; comorbidity showed relation with disability and QoL but to a lesser extent; self-reported mood symptoms were associated with poorer QoL; and disease duration correlated with motor impairment.
  
  
  CONCLUSIONS
  Motor impairment, disability, and QoL of newly diagnosed Parkinson patients show progression in the first 3 years. Older age at onset predicts worse progression rate of disability and impaired QoL over time. Female sex predicts slower progression of motor impairment and less decline of QoL.
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. b.post@amc.uva.nl
authors.forename: Bart
authors.initials: B
authors.lastname: Post
authors.forename: Dino
authors.initials: D
authors.lastname: Muslimovic
authors.forename: Nan
authors.initials: N
authors.lastname: van Geloven
authors.forename: Johannes D
authors.initials: JD
authors.lastname: Speelman
authors.forename: Ben
authors.initials: B
authors.lastname: Schmand
authors.forename: Rob J
authors.initials: RJ
authors.lastname: de Haan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index