title: Concordance between severity of disease, prevalence of nonmotor symptoms, patient-reported quality of life and disability and use of medication in Parkinson's disease.
abstract: The aim of this study was to test the concordance between disease severity, prevalence of nonmotor symptoms, age, health-related quality of life (HRQoL), disability and medication use in patients with Parkinson's disease (PD). Severity was classified with the Hoehn and Yahr (HY) scale and Levodopa Equivalent Daily Dose (LEDD) calculated. HRQoL was evaluated with the SF-36, disability with the WHO-DAS II and nonmotor symptoms with the NMSQuest. Patients were clustered using SF-36 and WHO-DAS II into three groups covering the continuum from low disability and HRQoL, to severe disability and HRQoL decrement. Contingency Coefficient were used to verify the relationships between clusters and HY stage; ANOVA to evaluate differences in NMS, age and LEDD between clusters; odds ratio to test the likelihood of taking levodopa or dopamine agonist and being member of the three clusters; t test to evaluate differences in LEDD between patients with HY ≥3 or ≤2. Eighty-six patients were clustered: 48 had low disability and HRQoL decrement, 18 intermediate disability and HRQoL decrement and 20 high disability and HRQoL decrement. A significant relationship was found between PD severity groups, HRQoL and disability profiles. No differences for age and LEDD were observed in the three groups, and those with more disability and lower HRQoL reported a higher number of nonmotor symptoms; patients in HY ≥3 were prescribed higher doses of drugs. In conclusion, we found a substantial concordance between PD staging, prevalence of nonmotor symptoms and patient-reported HRQoL and disability measures. In our opinion, the SF-36 and the WHO-DAS II can be used for profiling patients.
authors.affiliation: Neurology, Public Health and Disability Unit-Scientific Directorate, Neurological Institute C. Besta, IRCCS Foundation, Via Celoria 11, 20133 Milan, Italy. araggi@istituto-besta.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Raggi
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
authors.forename: Venusia
authors.initials: V
authors.lastname: Covelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Albanese
authors.forename: Paola
authors.initials: P
authors.lastname: Soliveri
authors.forename: Francesco
authors.initials: F
authors.lastname: Carella
authors.forename: Luigi
authors.initials: L
authors.lastname: Romito
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life; D057566:Self Report; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
references.citation: Mov Disord. 2010 Nov 15;25(15):2649-53
references.pmid: 21069833
references.citation: Qual Life Res. 2009 Nov;18(9):1219-37
references.pmid: 19714487
references.citation: J Neurol. 1998 May;245 Suppl 1:S10-4
references.pmid: 9617716
references.citation: Headache. 2010 Nov;50(10):1576-86
references.pmid: 21029083
references.citation: Mov Disord. 2010 Apr 30;25(6):704-9
references.pmid: 20437539
references.citation: N Engl J Med. 2000 May 18;342(20):1484-91
references.pmid: 10816186
references.citation: Mov Disord. 2007 Mar 15;22(4):451-60; quiz 600
references.pmid: 17133526
references.citation: Mov Disord. 2011 Feb 15;26(3):399-406
references.pmid: 21264941
references.citation: J Am Geriatr Soc. 2004 May;52(5):784-8
references.pmid: 15086662
references.citation: Mov Disord. 2008 Oct 15;23(13):1897-905
references.pmid: 18709681
references.citation: Neurol Sci. 2011 Jun;32(3):387-92
references.pmid: 21170564
references.citation: Mov Disord. 2010 Nov 15;25(15):2493-500
references.pmid: 20922807
references.citation: Lancet. 2009 Jun 13;373(9680):2055-66
references.pmid: 19524782
references.citation: Mov Disord. 2007 Aug 15;22(11):1623-9
references.pmid: 17546669
references.citation: Parkinsonism Relat Disord. 2011 Jan;17(1):1-9
references.pmid: 20833572
references.citation: Lancet Neurol. 2006 Jun;5(6):525-35
references.pmid: 16713924
references.citation: Mov Disord. 2008 Apr 30;23(6):790-6
references.pmid: 18361474
references.citation: Neurology. 1967 May;17(5):427-42
references.pmid: 6067254
references.citation: Disabil Rehabil. 2011;33(15-16):1440-6
references.pmid: 21091047
references.citation: J Neurol. 2011 Mar;258(3):494-9
references.pmid: 20957384
references.citation: Parkinsonism Relat Disord. 2012 Jan;18(1):35-9
references.pmid: 21880537
references.citation: Spine (Phila Pa 1976). 2000 Dec 15;25(24):3130-9
references.pmid: 11124729
references.citation: J Neurol. 2010 Jan;257(1):98-102
references.pmid: 19669388
references.citation: Bull World Health Organ. 2010 Nov 1;88(11):815-23
references.pmid: 21076562
references.citation: J Neurol Neurosurg Psychiatry. 2008 Apr;79(4):368-76
references.pmid: 18344392
references.citation: JAMA. 2000 Oct 18;284(15):1931-8
references.pmid: 11035889
references.citation: J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):181-4
references.pmid: 1564476
references.citation: Mov Disord. 2011 Feb 15;26(3):449-56
references.pmid: 21312273
references.citation: J Neurol. 2010 Apr;257(4):638-45
references.pmid: 19946784
references.citation: J Neurol. 2009 Aug;256 Suppl 3:293-8
references.pmid: 19711119
references.citation: Mov Disord. 2006 Mar;21(3):343-53
references.pmid: 16211594
references.citation: Neurology. 2008 Jun 3;70(23):2241-7
references.pmid: 18519873
references.citation: J Neurol. 2011 Aug;258(8):1513-7
references.pmid: 21394490
references.citation: Eur Neurol. 2007;57(3):161-5
references.pmid: 17213723
references.citation: Health Qual Life Outcomes. 2010 May 19;8:51
references.pmid: 20482853
references.citation: Parkinsonism Relat Disord. 2011 May;17(4):265-9
references.pmid: 21310647
references.citation: Neurol Sci. 2010 Feb;31(1):41-5
references.pmid: 19816655
references.citation: Lancet. 2000 Apr 15;355(9212):1315-9
references.pmid: 10776744