Carod-Artal Francisco Javier, Vargas Antonio Pedro, Martinez-Martin Pablo
Department of Neurology, The Sarah Network of Rehabilitation Hospitals, Sarah Hospital, Brasilia DF, Brazil.
Neuroepidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
Mov Disord. 2007 Jul 30;22(10):1408-1415. doi: 10.1002/mds.21408.
Our objective was to identify determinants of health-related quality of life (HRQoL) in a cohort of Brazilian patients with Parkinson's disease (PD). Patients were evaluated by means of the Hoehn and Yahr staging (H&Y), Unified Parkinson's Disease Rating Scale (UPDRS), Schwab and England scale (S&E), Mini-Mental State Exam, Geriatric Depression Scale, and Hospital Anxiety and Depression Scale (HADS). HRQol was assessed using the MOS-Short-Form 36 (SF-36), the Parkinson's disease Questionnaire (PDQ-39), and the Scales for Outcomes in Parkinson's Disease-Psychosocial Questionnaire (SCOPA-PS). 144 patients were evaluated (mean age 62 years; 53.5% men; mean duration of illness 6.6 years; median H&Y, 2 (range: 1-4). Mean SCOPA-PS and PDQ-39 Summary Index (SI) were 39.2 and 40.7, respectively. Both, PDQ-39 and SCOPA-PS SIs correlated at a moderate level (r = 0.30-0.50) with H&Y, S&E, total UPDRS, HADS subscales, and SF-36 Physical and Mental Components. PDQ-39 and SCOPA-PS were closely associated (r = 0.73). HRQoL significantly deteriorated as H&Y progressed, as a whole. Mood disturbances, disability, motor complications, and education were independent predictors of HRQoL in the multivariate analysis model. In PD Brazilian patients, HRQoL correlated significantly with diverse measures of severity. Depression showed to be the most consistent determinant of HRQoL, followed by disability, motor complications, and education years. There was a close association between the PDQ-39 and SCOPA-PS summary scores.
我们的目标是确定巴西帕金森病（PD）患者队列中健康相关生活质量（HRQoL）的决定因素。通过霍恩和亚尔分级（H&Y）、统一帕金森病评定量表（UPDRS）、施瓦布和英格兰量表（S&E）、简易精神状态检查表、老年抑郁量表以及医院焦虑抑郁量表（HADS）对患者进行评估。使用医学结局研究简明健康调查量表（SF-36）、帕金森病问卷（PDQ-39）以及帕金森病心理社会问卷结局量表（SCOPA-PS）评估HRQoL。对144例患者进行了评估（平均年龄62岁；男性占53.5%；平均病程6.6年；H&Y中位数为2（范围：1 - 4）。SCOPA-PS和PDQ-39总结指数（SI）的平均值分别为39.2和40.7。PDQ-39和SCOPA-PS的SI与H&Y、S&E、UPDRS总分、HADS分量表以及SF-36身体和心理成分均呈中等程度相关（r = 0.30 - 0.50）。PDQ-39和SCOPA-PS密切相关（r = 0.73）。总体而言，随着H&Y分级进展，HRQoL显著恶化。在多变量分析模型中，情绪障碍、残疾、运动并发症和受教育程度是HRQoL的独立预测因素。在巴西PD患者中，HRQoL与多种严重程度指标显著相关。抑郁是HRQoL最一致的决定因素，其次是残疾、运动并发症和受教育年限。PDQ-39和SCOPA-PS总结分数之间存在密切关联。
