title: Non-motor symptoms and quality of life in subjects with mild parkinsonian signs.
abstract: BACKGROUND
  Mild parkinsonian signs (MPS) are frequent in the elderly population and associated with the presence of risk markers for Parkinson's disease (PD). Both MPS and non-motor signs may be present in prodromal PD and may significantly impair quality of life (QoL).
  
  
  OBJECTIVE
  To disentangle the contribution of motor impairment and extra-motor manifestations to QoL in subjects with MPS (n=63), manifest PD (n=69), disorders with motor symptoms due to non-neurodegenerative diseases (n=213) and healthy controls (n=258).
  
  
  METHODS
  Subjects with MPS, healthy controls, disease controls (patients with motor impairment due to, eg, arthrosis and spondylosis), and PD patients (total n=603) were selected from a large epidemiological longitudinal study, the EPIPARK cohort. Motor function was determined using the UPDRSIII protocol, and information on depressive symptoms, anxiety, sleep, and QoL was assessed via rating scales and data were analyzed.
  
  
  RESULTS
  Depressive symptoms, anxiety, and sleep problems were equally frequent in the MPS group and controls. Health-related QoL was slightly reduced in the MPS group. Motor impairment and its extent was comparable between the MPS group and disease controls (UPDRSIII 5-6 points). Higher motor dysfunction was associated with lower QoL. Depressive symptoms, but not anxiety and daytime sleepiness, was significant predictors of general QoL, independent of motor function.
  
  
  CONCLUSIONS
  Quality of life is slightly decreased in an elderly population with MPS. QoL is associated with severity of motor impairment but also with non-motor aspects, ie, depressive symptoms. Follow-up studies in large cohorts are warranted to determine the natural course of MPS and its impact on QoL.
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Prasuhn
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Piskol
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.|Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
authors.forename: E-J
authors.initials: EJ
authors.lastname: Vollstedt
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.|Department of Neurology, University of Lübeck, Lübeck, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Graf
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.|Kurt Singer Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin, Berlin, Germany.|Berlin Center for Musicians' Medicine, Charité - University Medicine Berlin, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.|Department of Neurology, University of Lübeck, Lübeck, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Tadic
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.|Department of Neurology, University of Lübeck, Lübeck, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Tunc
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Hampf
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Warrlich
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Bibergeil
authors.affiliation: Department of Neurology, Westküstenklinikum Heide, Heide, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Hagenah
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Klein
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.|Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kasten
authors.affiliation: Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.|Department of Neurology, University of Lübeck, Lübeck, Germany.
authors.forename: N
authors.identifier: http://orcid.org/0000-0001-5969-6899
authors.initials: N
authors.lastname: Brüggemann
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology*; D016022:Case-Control Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010300:Parkinson Disease / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000453:epidemiology*
keywords: mild parkinsonian signs; prodromal Parkinson's disease; quality of life