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使用三种不同方法评估德国帕金森病患者队列的生活质量。

Quality of life in a German cohort of Parkinson's patients assessed with three different measures.

机构信息

Geriatric Centre Haus Berge, Contilia GmbH, University Hospital Essen, Essen, Germany.

Deutsches Rheumaforschungszentrum-ein Leibniz Institut, Berlin, Germany.

出版信息

J Neurol. 2018 Nov;265(11):2713-2722. doi: 10.1007/s00415-018-9047-9. Epub 2018 Sep 12.

Abstract

BACKGROUND

Parkinson's disease (PD) is characterized by severe motor and non-motor symptoms reducing patients' quality of life (QoL). Instruments have been well established for QoL assessments in PD, including the EuroQol (EQ-5D), the Parkinson's disease questionnaire (PDQ-39), or rather uncommon, like the WHOQOL-100. So far, the impact of variables has been investigated for each of these measures separately in different study populations, limiting the comparability of the results. Thus, this study compared the EQ-5D, PDQ-39, and the WHOQOL-100 (with its short-form WHOQOL-BREF) in the same study population.

METHODS

Seventy-five PD outpatients were assessed in a prospective study, including disease severity according to Hoehn and Yahr stage (HY) and Unified Parkinson Disease Rating Scale (UPDRS). The Geriatric Depression Scale (GDS-15) screened for depression.

RESULTS

Decreased QoL was found with all three instruments. In multivariate models, sex and treatment complications had an impact on QoL according to all three measures, while duration of PD and HY was not associated with QoL in any of them. Depression was relevant for the WHOQOL-100/WHOQOL-BREF and the PDQ-39, but not for the EQ-5D. The total variances explained by the WHOQOL-100, WHOQOL-BREF, PDQ-39, and the EQ-5D were 0.27, 0.34, 0.70, and 0.50, respectively.

CONCLUSIONS

The associations between clinical aspects of PD and QoL vary substantially among all three measures. Importantly, depression as a frequent comorbidity in PD is underestimated by the EQ-5D, but not by the PDQ-39 and the WHOQOL-100/WHOQOL-BREF. In turn, motor impairments are underestimated by the latter and associated strongest with QoL in the EQ-5D.

摘要

背景

帕金森病(PD)的特征是严重的运动和非运动症状,降低了患者的生活质量(QoL)。已经有多种工具用于 PD 的 QoL 评估,包括 EuroQol(EQ-5D)、帕金森病问卷(PDQ-39),或者不太常见的,如 WHOQOL-100。到目前为止,这些措施中的每一项都在不同的研究人群中针对变量的影响进行了研究,限制了结果的可比性。因此,本研究在同一研究人群中比较了 EQ-5D、PDQ-39 和 WHOQOL-100(及其简短形式 WHOQOL-BREF)。

方法

75 名 PD 门诊患者参与了一项前瞻性研究,包括根据 Hoehn 和 Yahr 分期(HY)和统一帕金森病评定量表(UPDRS)评估的疾病严重程度。老年抑郁量表(GDS-15)筛查抑郁。

结果

所有三种工具都发现 QoL 下降。在多变量模型中,性别和治疗并发症根据所有三种措施对 QoL 有影响,而 PD 的持续时间和 HY 与任何一种措施的 QoL 均无关。抑郁与 WHOQOL-100/WHOQOL-BREF 和 PDQ-39 相关,但与 EQ-5D 无关。WHOQOL-100、WHOQOL-BREF、PDQ-39 和 EQ-5D 的总方差解释分别为 0.27、0.34、0.70 和 0.50。

结论

PD 的临床方面与 QoL 之间的关联在所有三种措施中差异很大。重要的是,PD 中常见的合并症抑郁被 EQ-5D 低估,但 PDQ-39 和 WHOQOL-100/WHOQOL-BREF 没有低估。反过来,运动障碍被后者低估,与 EQ-5D 中 QoL 的关联最强。

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