Movement Disorders Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Arch Med Res. 2013 Feb;44(2):110-4. doi: 10.1016/j.arcmed.2013.01.005. Epub 2013 Jan 30.
Parkinson's disease (PD) is the second most common chronic neurodegenerative disorder. PD is clinically characterized by a constellation of motor and nonmotor symptoms that may have a direct effect on daily activities as well as in the quality of life of the patient. Identifying the symptoms more closely associated with a poor quality of life is central on improving the medical care of the patient. We undertook this study to identify and describe the clinical and demographic factors that predict health-related quality of life among Mexican patients with PD.
One hundred seventy-seven patients with Parkinson's disease were included. Patients were evaluated using the following clinimetric instruments: motor subscale of the Unified Parkinson's disease rating scale, Hoehn and Yahr stage, Non-motor Symptoms Questionnaire, Parkinson's disease Questionnaire (PDQ-39) and the Mini Mental Status Examination.
Multivariate analysis showed that the main factors associated with a poor quality of life were motor impairment (β = 0.27, p <0.001) and the number of nonmotor symptoms (β = 2.17, p <0.001). The main nonmotor domains impacting on the quality of life were depression/anxiety (β = 6.36, p <0.001), cardiovascular (β = 5.39, p = 0.001), memory (β = 4.64, p <0.001) and miscellaneous (β = 3.15, p = 0.001).
Both motor and mainly nonmotor symptoms are negatively associated with health-related quality of life in patients with PD and should be appropriately attended in order to improve patient care.
帕金森病(PD)是第二常见的慢性神经退行性疾病。PD 临床上以一系列运动和非运动症状为特征,这些症状可能直接影响日常活动以及患者的生活质量。确定与生活质量较差密切相关的症状是改善患者医疗护理的关键。我们进行这项研究是为了确定和描述与墨西哥 PD 患者健康相关生活质量相关的临床和人口统计学因素。
共纳入 177 例帕金森病患者。使用以下临床计量学工具评估患者:统一帕金森病评定量表的运动子量表、Hoehn 和 Yahr 分期、非运动症状问卷、帕金森病问卷(PDQ-39)和简易精神状态检查。
多变量分析显示,与生活质量较差相关的主要因素是运动障碍(β=0.27,p<0.001)和非运动症状的数量(β=2.17,p<0.001)。对生活质量影响最大的主要非运动领域是抑郁/焦虑(β=6.36,p<0.001)、心血管(β=5.39,p=0.001)、记忆(β=4.64,p<0.001)和杂项(β=3.15,p=0.001)。
运动和主要非运动症状都与 PD 患者的健康相关生活质量呈负相关,应适当关注,以改善患者护理。