title: Rural living and health-related quality of life in Australians with Parkinson's disease.
abstract: BACKGROUND
  The motor and non-motor symptoms associated with idiopathic Parkinson's disease (PD) may compromise the health-related quality of life (HRQOL) of some individuals living with this debilitating condition. Although growing evidence suggests that PD may be more prevalent in rural communities, there is little information about the life quality of these individuals. This study examines whether HRQOL ratings vary in relation to rural and metropolitan life settings.
  
  
  METHODS
  An analytic cross-sectional study was conducted to compare the HRQOL of two separate samples of people with PD living in metropolitan Melbourne and rural Victoria. The metropolitan sample consisted of 210 individuals who had participated in the baseline assessment for an existing clinical trial. The rural sample comprised 24 participants who attended community-based rehabilitation programs and support groups in rural Victoria. Health-related quality of life was quantified using the Parkinson's Disease Questionnaire-39 (PDQ-39).
  
  
  RESULTS
  The HRQOL of participants in rural Australia differed from individuals living in a large metropolitan city (p=0.025). Participants in rural Australia reported worse overall HRQOL, after controlling for differences in disease duration. Their overall HRQOL was lower than for city dwellers. Rural living was also found to be a significant negative predictor of HRQOL (β=0.14; 95% CI -1.27 to -0.08; p=0.027).
  
  
  CONCLUSIONS
  The findings of this study suggest that some people with PD living in rural Victoria perceive their HRQOL to be relatively poor. In order to minimise the debilitating consequences of this disease, further studies examining the factors that may contribute to the HRQOL of individuals living in rural and remote areas are required.
authors.affiliation: Physiotherapy Department, Alfred Health, Melbourne, Victoria, Australia. s.soh@alfred.org.au
authors.forename: S-E
authors.initials: SE
authors.lastname: Soh
authors.forename: J L
authors.initials: JL
authors.lastname: McGinley
authors.forename: J J
authors.initials: JJ
authors.lastname: Watts
authors.forename: R
authors.initials: R
authors.lastname: Iansek
authors.forename: M E
authors.initials: ME
authors.lastname: Morris
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012424:Rural Population / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012944:Social Support; D014739:Victoria / Q000453:epidemiology