Adam Margolius1, Fernando Cubillos2, Ying He3, Samuel Wu4, Peter Schmidt5, Tanya Simuni6. 1. Department of Neurology, Northwestern University, 303 East Chicago Avenue Ward 12-140, Chicago, IL, 60611, USA. Electronic address: margola@ccf.org. 2. National Parkinson Foundation, 200 SE 1st Street, Suite 800, Miami, FL, 33131, USA. Electronic address: fcubillos@parkinson.org. 3. Department of Mathematics, Clarkson University, 8 Clarkson Avenue, Potsdam, NY, 13699, USA. Electronic address: yhe@clarkson.edu. 4. Department of Biostatistics, University of Florida, 2004 Mowry Road, 5th Floor CTRB P.O. Box 117450, Gainesville, FL, 32611, USA. Electronic address: sw45@ufl.edu. 5. National Parkinson Foundation, 200 SE 1st Street, Suite 800, Miami, FL, 33131, USA. Electronic address: pschmidt@parkinson.org. 6. Department of Neurology, Northwestern University, 303 East Chicago Avenue Ward 12-140, Chicago, IL, 60611, USA. Electronic address: tsimuni@nmff.org.
Abstract
OBJECTIVE: To determine predictors of clinically meaningful change in Health-Related Quality of Life (HRQL) in patients with Parkinson's disease (PD). BACKGROUND: There is limited literature on longitudinal predictors of change in HRQL in PD. METHODS: Data were collected from the National Parkinson Foundation Quality Improvement Initiative (NPF-QII) registry, a multicenter, longitudinal observational study. HRQL is measured by the Parkinson's Disease Questionnaire-39 (PDQ-39). We calculated the PDQ-39 change between every two consecutive visits and generated binary outcomes using the threshold for clinically meaningful change (previously determined to be 1.6). We used chi-squared tests for discrete and t-test for continuous variables for baseline characteristic comparison between patient groups of interest. Generalized linear mixed models with repeated measures were used for identifying the predictors of whether PDQ-39 outcomes worsen over time. RESULTS: Of 8041 subjects enrolled, 5250 had at least one follow-up visit and were included in the analysis. Subjects were separated into two groups, "worse" and "not worse" based on PDQ-39 change >1.6 across consecutive visits. The "worse" group was more likely to be older (p = 0.001), to have motor fluctuations (p = 0.011), be on cognitive enhancers (p = 0.01), and to have more impaired immediate five-word recall (p = 0.04). The "non-worse" group was more likely to have rest tremor (p = 0.003), and to utilize social work/counseling (p = 0.046). CONCLUSIONS: The majority of predictors of worsening of HRQL are baseline disease and demographic characteristics that are difficult to modify. The positive effect of social service/counseling is intriguing and important to further explore in controlled interventional studies.
OBJECTIVE: To determine predictors of clinically meaningful change in Health-Related Quality of Life (HRQL) in patients with Parkinson's disease (PD). BACKGROUND: There is limited literature on longitudinal predictors of change in HRQL in PD. METHODS: Data were collected from the National Parkinson Foundation Quality Improvement Initiative (NPF-QII) registry, a multicenter, longitudinal observational study. HRQL is measured by the Parkinson's Disease Questionnaire-39 (PDQ-39). We calculated the PDQ-39 change between every two consecutive visits and generated binary outcomes using the threshold for clinically meaningful change (previously determined to be 1.6). We used chi-squared tests for discrete and t-test for continuous variables for baseline characteristic comparison between patient groups of interest. Generalized linear mixed models with repeated measures were used for identifying the predictors of whether PDQ-39 outcomes worsen over time. RESULTS: Of 8041 subjects enrolled, 5250 had at least one follow-up visit and were included in the analysis. Subjects were separated into two groups, "worse" and "not worse" based on PDQ-39 change >1.6 across consecutive visits. The "worse" group was more likely to be older (p = 0.001), to have motor fluctuations (p = 0.011), be on cognitive enhancers (p = 0.01), and to have more impaired immediate five-word recall (p = 0.04). The "non-worse" group was more likely to have rest tremor (p = 0.003), and to utilize social work/counseling (p = 0.046). CONCLUSIONS: The majority of predictors of worsening of HRQL are baseline disease and demographic characteristics that are difficult to modify. The positive effect of social service/counseling is intriguing and important to further explore in controlled interventional studies.
Authors: Eduardo Candel-Parra; María Pilar Córcoles-Jiménez; Victoria Delicado-Useros; Marta Carolina Ruiz-Grao; Antonio Hernández-Martínez; Milagros Molina-Alarcón Journal: Int J Environ Res Public Health Date: 2022-01-07 Impact factor: 3.390