Kristina Rosqvist1, Per Odin1,2, Stefan Lorenzl3,4, Wassilios G Meissner5,6,7,8, Bastiaan R Bloem9, Joaquim J Ferreira10, Richard Dodel11, Anette Schrag12. 1. Division of Neurology, Department of Clinical Sciences Lund, Faculty of Medicine Lund University Lund Sweden. 2. Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics Skåne University Hospital Lund Sweden. 3. Interdisciplinary Center for Palliative Medicine and Clinic for Neurology University of Munich, the Großhadern clinic Munich Germany. 4. Institute of Nursing Science and Practice Salzburg Austria. 5. Department of Neurology the University Hospital of Bordeaux Bordeaux France. 6. Université de Bordeaux, Institut des Maladies Neurodégénératives, CNRS, UMR 5293 Bordeaux France. 7. Department of Medicine University of Otago Christchurch New Zealand. 8. New Zealand Brain Research Institute Christchurch New Zealand. 9. Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour Nijmegen The Netherlands. 10. Faculty of Medicine Molecular Medicine Institute, the University of Lisbon Lisbon Portugal. 11. Department of Geriatric Medicine University Hospital Essen Essen Germany. 12. Queen Square Institute of Neurology University College London London UK.
Abstract
BACKGROUND: There is limited knowledge on health-related quality of life (HRQoL) in late-stage Parkinson's disease (PD). OBJECTIVE: To assess factors associated with HRQoL in patients with late-stage PD, with a focus on health care provision. METHODS: The Care of Late Stage Parkinsonism (CLaSP) project is the largest study on late-stage PD to date. The current study analyzed data of 401 patients from 6 European countries in whom HRQoL was assessed with the 8-item PD Questionnaire in patients without dementia. Factors potentially associated with HRQoL were assessed and examined in linear regression analyses. RESULTS: Better HRQoL was associated with living at home, greater independence in activities of daily living (Schwab and England Scale), less severe disease (Hoehn and Yahr stage), better motor function (Unified PD Rating Scale Part III), and lower non-motor symptoms burden (Non-Motor Symptoms Scale [NMSS]) across all NMSS domains. Having a PDspecialist as physician for PD, contact with a PDnurse, and no hospital admission during the past 3 months were associated with better HRQoL, but having seen a physiotherapist or occupational therapist was associated with worse HRQoL. CONCLUSIONS: The results emphasize the importance of optimizing treatment for motor and multiple non-motor symptoms to improve HRQoL in patients with late-stage PD. PD-specific health care resources, particularly PDnurses, are likely important in addressing issues to improve HRQoL in this population. Worse HRQoL in those who had recently seen a physiotherapist or occupational therapist may reflect referral based on factors not measured in this study.
BACKGROUND: There is limited knowledge on health-related quality of life (HRQoL) in late-stage Parkinson's disease (PD). OBJECTIVE: To assess factors associated with HRQoL in patients with late-stage PD, with a focus on health care provision. METHODS: The Care of Late Stage Parkinsonism (CLaSP) project is the largest study on late-stage PD to date. The current study analyzed data of 401 patients from 6 European countries in whom HRQoL was assessed with the 8-item PD Questionnaire in patients without dementia. Factors potentially associated with HRQoL were assessed and examined in linear regression analyses. RESULTS: Better HRQoL was associated with living at home, greater independence in activities of daily living (Schwab and England Scale), less severe disease (Hoehn and Yahr stage), better motor function (Unified PD Rating Scale Part III), and lower non-motor symptoms burden (Non-Motor Symptoms Scale [NMSS]) across all NMSS domains. Having a PDspecialist as physician for PD, contact with a PDnurse, and no hospital admission during the past 3 months were associated with better HRQoL, but having seen a physiotherapist or occupational therapist was associated with worse HRQoL. CONCLUSIONS: The results emphasize the importance of optimizing treatment for motor and multiple non-motor symptoms to improve HRQoL in patients with late-stage PD. PD-specific health care resources, particularly PDnurses, are likely important in addressing issues to improve HRQoL in this population. Worse HRQoL in those who had recently seen a physiotherapist or occupational therapist may reflect referral based on factors not measured in this study.
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