The Effect of Non-motor Symptoms on Health-related Quality of Life in Parkinson’s Disease
|School||Hebei Medical University|
|Keywords||Parkinson’s disease non-motor symptoms sleep disturbance depression health-related quality of life|
Objective: The purposes of this study were:(1)to describe the levels ofnon-motor symptoms(NMS)(including neuropsychiatric complications, sleepdisturbance, autonomic dysfunction, gastrointestinal symptoms, sensorysymptoms and fatigue)and health-related quality of life(HRQOL)in patientswith Parkinson’s disease(PD);(2)to explore the influenced factors of NMS andHRQOL in the subjects;(3)to explore the relationship between NMS andHRQOL in these subjects.Methods: A descriptive and correlative research design was used in thisstudy. By convenient sampling,108PD patients from the First Hospital ofHebei Medical University were recruited into this study. NMS was assessedby the Non-Motor Symptoms Scale for Parkinson’s disease (NMSS), HRQOLwas evaluated by the39-item Parkinson’s disease Questionnaire (PDQ39).Other variables, including socio-demographic data and disease duration,severity of disease, motor symptoms, were assessed by Social-demographicquestionnaire, the Modified Hoehn and Yahr Staging and Unified ParkinsonDisease Rating Scale (UPDRSIII). Statistical analysis was performed usingSPSS13.0software.Results:1.All PD patients (100%) suffered from NMS with a generalscore at121.23±49.45. Among these NMS,1evel of sleep disturbanceincluding insomnia and RLS was ranked the highest, followed byneuropsychiatric symptoms (cognitive impairment, anxiety and depression),autonomic dysfunction (nocturia increase, urgency and frequency ofmicturition) and gastrointestinal symptoms (constipation).2. PD patients’ NMS were influenced by their social-demographic data(gender and age), disease characteristics (the disease duration, severity of thedisease and motor symptoms).(1)NMS were influenced by gender and age. The level of NMS in female PD patients was significantly higher than that in male patients (t=-2.306, P＜0.05); the average level of gastrointestinal symptoms in older PD patients wassignificantly higher than those in younger patients (t=-3.038, P＜0.01).(2)The general level of NMS was significantly positively associated withthe disease duration, severity of the disease and the general level of motorsymptoms (r=0.230~0.358, P＜0.01).3. PD patients’ HRQOL was impaired with a general score at42.95±14.71.Activities of daily living, mobility, emotional well-being and stigma werethe most seriously influenced.4. PD patients’ HRQOL was influenced by social-demographic data(gender, age and marriage status), disease characteristics (the disease duration,severity of the disease and motor symptoms) and NMS.(1)PD patients’ HRQOL was influenced by their gender, age andmarriage status. Female, older and bereaved patients had significantly lowerHRQOL than that of others (χ2=-3.361~-2.181, P＜0.05).(2)The general level of PD patients’ HRQOL was significantly positivelyassociated with the disease duration, severity of the disease and the level ofmotor symptoms (r=0.256~0.451, P＜0.05).5. The general level of HRQOL was significantly positively associatedwith the general level of NMS(r=0.692, P＜0.01).Conclusions:(1) Non-motor symptoms (NMS) were very common in PDpatients. Sleep disturbance (insomnia and restless leg syndrome) were themost severe symptoms among PD patients.(2)PD patients’ NMS wereinfluenced by their gender, age, the disease duration, severity of the diseaseand motor symptoms.(3)PD patients’ HRQOL was impaired. Activities ofdaily living, mobility, emotional well-being and stigma were the mostseriously influenced. PD patients’ HRQOL was influenced by their gender,age, marriage status, the disease duration, severity of the disease, motorsymptoms and NMS.(4)NMS had more negative impact on PD patients’HRQOL than motor symptoms. The higher level of NMS the patients had, thelower their HRQOL would be.