title: Prevalence of fatigue in Parkinson disease and its clinical correlates.
abstract: OBJECTIVE
  To assess in a noninterventional setting the prevalence and severity of fatigue in patients with Parkinson disease (PD).
  
  
  METHODS
  This was a cross-sectional study conducted in Italian patients with PD. Objectives included the evaluation of the current prevalence and severity of fatigue in patients with PD measured using the 16-item Parkinson Fatigue Scale (PFS-16), distressing fatigue (defined as a PFS-16 mean score ≥3.3), and assessment of its clinical correlates.
  
  
  RESULTS
  A total of 402 patients were enrolled and 394 patients completed the PFS-16 questionnaire with a PFS-16 mean (±SD) score of 2.87 ± 0.99. Of these, 136 patients (33.8%) reported distressing fatigue (PFS-16 mean score ≥3.3). Patients with distressing fatigue were older (p = 0.044) and had a longer duration of PD (p < 0.0001) than those without distressing fatigue. The presence of distressing fatigue was associated with higher total Unified Parkinson's Disease Rating Scale (UPDRS) scores, poorer quality of life (39-item Parkinson's Disease Questionnaire [PDQ-39]), worse social and psychological behaviors, a higher severity of depressive symptoms, and a higher prevalence of sleep disorders (all p < 0.001). Logistic regression analyses revealed that higher total UPDRS scores, female sex, depression, sleep disorders, as well as higher UPDRS activities of daily living scores and PDQ-39 mobility scores increase the likelihood of distressing fatigue in patients with PD.
  
  
  CONCLUSIONS
  Approximately one-third of patients with PD have distressing fatigue, which is significantly associated with depression and sleep disorders. The fact that the presence of fatigue worsens patient quality of life supports the need to better diagnose and treat this debilitating symptom.
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy. fabrizio.stocchi@sanraffaele.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Stocchi
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Abbruzzese
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ceravolo
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Cortelli
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: D'Amelio
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Maria F
authors.initials: MF
authors.lastname: De Pandis
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fabbrini
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pacchetti
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Pezzoli
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tessitore
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Canesi
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Iannacone
authors.affiliation: From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Zappia
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000503:physiopathology; D005221:Fatigue / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000145:classification / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology; D013997:Time Factors