title: Health-related quality of life in multiple system atrophy and progressive supranuclear palsy.
abstract: OBJECTIVE
  Multiple system atrophy (MSA) and progressive supranuclear palsy (PSP), known as atypical parkinsonian syndromes (APS), are neurodegenerative disorders with severe disability and decreased life expectancy. Little is known about the health-related quality of life (HrQoL) and its determinants in patients with those disorders. The objective of our cross-sectional study was to evaluate the HrQoL in patients with APS and to identify the determinants of HrQoL.
  
  
  METHODS
  A total of 101 consecutive patients with MSA (n = 54) and PSP (n = 47) were recruited in four German neurological centers. Disease severity was assessed using the Hoehn and Yahr stages and the Unified MSA Rating Scale. The HrQoL was evaluated using the EuroQol instrument (EQ-5D and EQ-VAS). Independent determinants of HrQoL were identified in multiple regression analyses.
  
  
  RESULTS
  The mean EQ-VAS score was 52% lower than that reported for the general population (36.9 ± 18.3 vs. 77.4 ± 19.0). Of the study participants, 63% reported severe problems in at least one dimension of the EQ-5D. Cerebellar dysfunction was associated with a more considerable reduction of HrQoL. Independent determinants of reduced HrQoL were female gender, <12 years of education, disease severity, a decreased number of persons in the household and depression.
  
  
  CONCLUSIONS
  The HrQoL in MSA and PSP is considerably reduced. While therapeutic options in the treatment of motor symptoms remain restricted, greater attention should be paid to the treatment of depression, which was identified among independent determinants of HrQoL. Independent determinants of HrQoL should be considered when developing healthcare programs aimed at improving the HrQoL in APS.
authors.affiliation: Department of Neurology, Philipps University Marburg, Marburg, Germany.
authors.forename: Yaroslav
authors.initials: Y
authors.lastname: Winter
authors.forename: Annika E
authors.initials: AE
authors.lastname: Spottke
authors.forename: Maria
authors.initials: M
authors.lastname: Stamelou
authors.forename: Nicole
authors.initials: N
authors.lastname: Cabanel
authors.forename: Karla
authors.initials: K
authors.lastname: Eggert
authors.forename: Günter U
authors.initials: GU
authors.lastname: Höglinger
authors.forename: Friederike
authors.initials: F
authors.lastname: Sixel-Doering
authors.forename: Birgit
authors.initials: B
authors.lastname: Herting
authors.forename: Thomas
authors.initials: T
authors.lastname: Klockgether
authors.forename: Heinz
authors.initials: H
authors.lastname: Reichmann
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Oertel
authors.forename: Richard
authors.initials: R
authors.lastname: Dodel
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002908:Chronic Disease; D003863:Depression / Q000209:etiology / Q000523:psychology; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D015999:Multivariate Analysis; D009460:Neurologic Examination; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012737:Sex Factors; D012959:Socioeconomic Factors; D013494:Supranuclear Palsy, Progressive / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires