School of Psychology, Bangor University, Bangor, UK.
Int J Geriatr Psychiatry. 2014 Jan;29(1):68-76. doi: 10.1002/gps.3970. Epub 2013 Apr 29.
High-quality person-centred care for people with Parkinson's disease (PwPD) and their families relies on identifying and addressing factors that specifically impact on quality of life (QoL). Deficits in executive functions (EF) are common in Parkinson's disease, but their impact on PwPD and their caregivers is not well understood. The present study evaluated how EF contributes to QoL and health status for the PwPD and caregiver burden.
Sixty-five PwPD completed measures of QoL, health status and EF, and 50 caregivers rated the EF of the PwPD and their own burden. Multiple regression analyses examined predictors of QoL (general life, health and movement disorders domains), health status and caregiver burden.
Quality of life in the health and movement disorders domains was best explained by caregiver-rated EF, whereas QoL in the general life domain was best explained by level of depression. Health status was predicted by self-rated EF, with an objective EF measure also included in the regression model. Caregiver burden was best explained by caregiver-rated EF and disease severity, with general cognition and other factors also included in the regression model.
Executive functions-related behavioural problems may contribute to QoL and health status in PwPD and affect caregiver burden. The findings support the view that the concepts of subjective QoL and self-assessed health status are only partially related and should not be seen as identical. Adequate strategies to reduce the impact of EF deficits are needed as this may have the potential to improve QoL in PwPD.
为了实现高质量的以患者为中心的帕金森病（PwPD）患者及其家庭的护理，需要确定并解决那些对生活质量（QoL）有具体影响的因素。执行功能（EF）缺陷在帕金森病中较为常见，但人们对其对 PwPD 及其照顾者的影响仍知之甚少。本研究评估了 EF 如何影响 PwPD 及其照顾者的生活质量和健康状况，并评估了照顾者的负担。
65 名 PwPD 完成了生活质量、健康状况和 EF 评估，50 名照顾者评估了 PwPD 的 EF 和他们自己的负担。多元回归分析检查了生活质量（一般生活、健康和运动障碍领域）、健康状况和照顾者负担的预测因素。
健康和运动障碍领域的生活质量主要由照顾者评估的 EF 解释，而一般生活领域的生活质量主要由抑郁水平解释。健康状况由自我评估的 EF 预测，回归模型中还包括了客观的 EF 测量。照顾者负担主要由照顾者评估的 EF 和疾病严重程度解释，回归模型中还包括了一般认知和其他因素。
与执行功能相关的行为问题可能会影响 PwPD 的生活质量和健康状况，并影响照顾者的负担。研究结果支持这样一种观点，即主观生活质量和自我评估的健康状况这两个概念仅部分相关，不应视为相同。需要采取适当的策略来减轻 EF 缺陷的影响，因为这可能有潜力改善 PwPD 的生活质量。
