Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain.
Mov Disord. 2012 Feb;27(2):211-8. doi: 10.1002/mds.23872. Epub 2011 Jul 20.
The impact of apathy on health-related quality of life (HRQOL) in recently diagnosed Parkinson's disease (PD) has not been systematically investigated. The objective of this cross-sectional survey (ANIMO study) was to examine the contribution of apathy to HRQOL in a Spanish sample of recently diagnosed PD patients. PD patients, diagnosed within 2 years of inclusion, were recruited at 102 outpatient clinics in 82 communities throughout Spain. Apathy was quantified using the Lille Apathy Rating Scale and HRQOL with the EuroQol-5D questionnaire. A mean EuroQol-5D index score of 0.89 obtained from population references in Spain was used as the cutoff for this study. The relationship between apathy and the dichotomized EuroQol-5D index score (<0.89 [lower HRQOL] vs ≥0.89 [reference]) was examined using multiple logistic regression analysis, adjusting for sociodemographic and clinical variables. We consecutively recruited 557 patients (60.3% men) with a mean age of 68.8 ± 9.7 years. Apathy was diagnosed in 291 (52.2%) and was related to problems in each of the EuroQoL dimensions. Apathetic PD patients showed EuroQol-5D index scores significantly lower than those without apathy (0.64 vs 0.83). In an adjusted model, apathetic PD patients were 2.49 times more likely to have lower HRQOL than nonapathetic patients (odds ratio, 2.49; 95% confidence interval, 1.49-4.15, P < 0.01). Apathy is very common in those with recently diagnosed PD and is one of the major clinical determinants of HRQOL in this disease. It should be one of the primary concerns among clinicians who provide treatment to individuals affected by PD.
冷漠对近期诊断的帕金森病（PD）患者的健康相关生活质量（HRQOL）的影响尚未得到系统研究。本横断面调查（ANIMO 研究）的目的是在西班牙近期诊断的 PD 患者样本中，考察冷漠对 HRQOL 的影响。在西班牙 82 个社区的 102 个门诊中招募了在纳入后 2 年内被诊断为 PD 的患者。使用 Lille 冷漠量表和 EuroQol-5D 问卷来量化冷漠。使用西班牙人群参考资料得出的平均 EuroQol-5D 指数得分 0.89 作为本研究的截止值。使用多变量逻辑回归分析，调整社会人口统计学和临床变量后，考察了冷漠与二分的 EuroQol-5D 指数得分（<0.89 [较低的 HRQOL]与≥0.89 [参考]）之间的关系。我们连续招募了 557 名（60.3%为男性）平均年龄为 68.8±9.7 岁的患者。291 名（52.2%）患者被诊断为冷漠，并且在每个 EuroQoL 维度中都存在问题。冷漠的 PD 患者的 EuroQol-5D 指数得分明显低于非冷漠患者（0.64 比 0.83）。在调整后的模型中，冷漠的 PD 患者发生 HRQOL 较低的可能性是非冷漠患者的 2.49 倍（优势比，2.49；95%置信区间，1.49-4.15，P<0.01）。近期诊断的 PD 患者中冷漠非常常见，是该疾病 HRQOL 的主要临床决定因素之一。它应该成为为受 PD 影响的个体提供治疗的临床医生关注的主要问题之一。
