Progression of Fatigue in Early Parkinson's Disease: A 3-Year Prospective Cohort Study.

To explore the frequency, evolution, associated factors, and risk factors of fatigue over 3-year of prospective follow-up in a cohort of patients with early Parkinson's disease (PD). A total of 174 PD patients in the early stage were enrolled and quantitively assessed motor and non-motor symptoms using comprehensive scales including the Fatigue Severity Scale (FSS) annually. Each subject was categorized as PD with and without fatigue based on a cut-off mean value of 4 using FSS. The generalized estimating equation (GEE) was utilized to investigate the associated factors, and the stepwise binary logistic regression model was performed to explore the predictors. The frequency of fatigue was slightly changed (ranging from 35.1 to 40.4%) during the 3-year follow-up. The changed pattern of the frequency of fatigue was similar to that of anxiety. Fatigue was significantly associated with nocturnal sleep disorders (B 2.446, < 0.001), high Hamilton Anxiety Rating Scale (HAMA) score (B 1.072, = 0.011), and high Unified PD Rating Scale (UPDRS) III score (B 1.029, = 0.003) over time. High UPDRS III score [odds ratio (OR) 1.051, = 0.015] at baseline increased the risk of developing fatigue after 1-year; high LEDD (OR 1.002, = 0.037) increased the risk of developing fatigue after 2-year; and high LEDD (OR 1.003, = 0.049) and high HAMA score (OR 1.077, = 0.042) increased the risk of developing fatigue after 3-year. Our present study provided evidence of the longitudinal evolution of fatigue in patients with early PD and help clinical management of fatigue.