title: Impact of mild cognitive impairment on health-related quality of life in Parkinson's disease.
abstract: OBJECTIVE
  To assess the impact of mild cognitive impairment (MCI) or cognitive decline on health-related quality of life (HR-QOL) in Parkinson's disease (PD).
  
  
  METHODS
  HR-QOL measured by the Parkinson Disease Quality of Life Questionnaire (PDQ-39), MCI according to Movement Disorder Society Task Force criteria and cognitive decline from premorbid baseline were assessed in non-demented PD patients at 6 movement disorder clinics.
  
  
  RESULTS
  Among 137 patients, after adjusting for education, gender, disease duration, and Movement Disorder Society Unified Parkinson's Disease Rating Scale total score, MCI was associated with worse scores within the PDQ-39 dimension of communication (p = 0.008). Subjects were divided into tertiles of cognitive decline from premorbid level. Scores in the dimension of stigma were worst in the second tertile of cognitive decline (p = 0.03). MCI was associated with worse social support scores in the second tertile of cognitive decline (p = 0.008).
  
  
  CONCLUSIONS
  MCI and cognitive decline from premorbid baseline are associated with reduced HR-QOL in communication, stigma, and social support domains. The cognitive decline from premorbid baseline modifies the association between MCI and HR-QOL in PD and knowing both will allow a better appreciation of difficulties patients face in daily life.
authors.affiliation: Toronto Western Hospital, Toronto, Ont., Canada.
authors.forename: William
authors.initials: W
authors.lastname: Reginold
authors.forename: Sarah
authors.initials: S
authors.lastname: Duff-Canning
authors.forename: Christopher
authors.initials: C
authors.lastname: Meaney
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Armstrong
authors.forename: Susan
authors.initials: S
authors.lastname: Fox
authors.forename: Brandon
authors.initials: B
authors.lastname: Rothberg
authors.forename: Cindy
authors.initials: C
authors.lastname: Zadikoff
authors.forename: Nancy
authors.initials: N
authors.lastname: Kennedy
authors.forename: David
authors.initials: D
authors.lastname: Gill
authors.forename: Paul
authors.initials: P
authors.lastname: Eslinger
authors.forename: Fred
authors.initials: F
authors.lastname: Marshall
authors.forename: Mark
authors.initials: M
authors.lastname: Mapstone
authors.forename: Kelvin L
authors.initials: KL
authors.lastname: Chou
authors.forename: Carol
authors.initials: C
authors.lastname: Persad
authors.forename: Irene
authors.initials: I
authors.lastname: Litvan
authors.forename: Benjamin
authors.initials: B
authors.lastname: Mast
authors.forename: David
authors.initials: D
authors.lastname: Tang-Wai
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Lang
authors.forename: Connie
authors.initials: C
authors.lastname: Marras
mesh_terms: D000203:Activities of Daily Living; D060825:Cognitive Dysfunction / Q000150:complications / Q000523:psychology*; D003142:Communication; D003627:Data Interpretation, Statistical; D003863:Depression / Q000150:complications / Q000523:psychology; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D057545:Social Stigma; D012944:Social Support