title: Nonmotor symptoms in nursing home residents with Parkinson's disease: prevalence and effect on quality of life.
abstract: OBJECTIVE
  To determine the prevalence of nonmotor symptoms (NMS) in nursing home (NH) residents with Parkinson's disease (PD) and to establish the association with quality of life.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Nursing homes in the southeast of the Netherlands.
  
  
  METHODS
  Nursing home residents with PD and a Mini-Mental State Examination score of 18 or greater (N = 73; mean age 78.7, disease duration 10 years, mainly Hoehn and Yahr Stages 4 (38%) and 5 (49%)) underwent detailed examination to determine the prevalence of NMS.
  
  
  METHODS
  Validated instruments for PD-related NMS were used to examine the NH residents with PD. The overall burden of NMS, and autonomic problems in particular, were measured using the Non-Motor Symptoms Scale (NMSS). Depression, neuropsychiatric symptoms, sleep problems, cognitive dysfunction, and motor impairments were focused on in further detail using established clinimetric tests. Linear regression analysis was used to examine the relationship between these symptoms and quality of life, which was measured using the Parkinson's Disease Questionnaire (PDQ-8).
  
  
  RESULTS
  The NMSS revealed a mean of nearly 13 different NMS per resident. Autonomic problems (constipation, urinary urgency) were particularly prevalent (48-75% of residents). Depressive symptoms were present in 45%. The most prevalent neuropsychiatric symptoms other than depression were irritability and apathy. The most common sleep problems were overall poor nighttime sleep quality, daytime sleepiness, and nocturia. Cognitive problems were highly prevalent, and 77% of the residents met the criteria for PD-related dementia. High scores were also obtained for motor impairments. Mean PDQ-8 score was high, indicating poor quality of life. Poor quality of life was most strongly associated with the prevalence and severity of overall NMS burden (coefficient of determination = 0.45).
  
  
  CONCLUSIONS
  Nonmotor symptoms were highly prevalent in NH residents with PD. Quality of life was poor, largely because of NMS. Because many NMS are potentially treatable, diagnosis and treatment of these severely affected individuals deserve more attention.
authors.affiliation: Department of Neurology, Atrium Medical Center, Heerlen, the Netherlands; Department of Neurology, Nijmegen Center for Evidence Based Practice, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
authors.forename: Nico J
authors.initials: NJ
authors.lastname: Weerkamp
authors.forename: Gerrit
authors.initials: G
authors.lastname: Tissingh
authors.forename: Petra J E
authors.initials: PJ
authors.lastname: Poels
authors.forename: Systse U
authors.initials: SU
authors.lastname: Zuidema
authors.forename: Marten
authors.initials: M
authors.lastname: Munneke
authors.forename: Raymond T C M
authors.initials: RT
authors.lastname: Koopmans
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Parkinson's disease; nonmotor symptoms; nursing home; quality of life