Predictors of clinically significant quality of life impairment in Parkinson’s disease
Diego Santos‐García, Teresa de Deus Fonticoba, Carlos Cores, Guillermo Muñoz, Jose Manuel Paz González, Cristina Martínez Miró, Ester Suárez, Silvia Jesús, Miquel Aguilar, Pau Pástor, Lluís Planellás, Marina Cosgaya, Juan García Caldentey, Núria Caballol, Inés Legarda, Jorge Hernández‐Vara, Iria Cabo, Luis López Manzanares, Isabel González Aramburu, María A. Ávila Rivera, María José Catalán, Víctor Nogueira, Víctor Puente, M. Ruíz De Arcos, Carmen Borrué, Berta Solano Vila, María Álvarez Saúco, Lydia Vela, Sonia Escalante, Esther Cubo, Francisco Carrillo Padilla, Juan Carlos Martínez‐Castrillo, Pilar Sánchez Alonso, Maria G. Alonso Losada, Núria López Ariztegui, Itziar Gastón, Pedro Clavero, Jaime Kulisevsky, Marta Blázquez Estrada, Manuel Seijo, Javier Ruiz‐Martínez, Caridad Valero, Mónica Kurtis, Oriol de Fàbregues, Jessica González Ardura, Carlos Ordás, Luis M. López Díaz, Darrian McAfee, Pablo Martínez‐Martín, Pablo Mir, COPPADIS Study Group, Daniela A. Adarmes, Marta Almería, A. Alonso Cánovas, Fernando Alonso Frech, Rubén Alonso Redondo, Ignacio Álvarez, Ángel Aneiros Díaz, S. Arnáiz, Sonia López Arribas, A. Ascunce Vidondo, N. Bernardo Lambrich, H. Bejr-Kasem, M. Botí, Maríateresa Buongiorno, Carolina Cabello González, A. Cámara Lorenzo, H. Canfield Medina, Fátima Carrillo, Elena Casas, A. Cortina Fernández, A. Cots Foraster, A. Crespo Cuevas, Mónica Díez-Fairén, Julio Dotor García‐Soto, Elena Erro, E. Estelrich Peyret, N. Fernández Guillán, P. Gámez, Mercedes Gallego, Cristina Campos, J M García-Moreno, M. P. Gómez Garre, Víctor Gómez‐Mayordomo, J. González Aloy, B. González García, M. J. González Palmás, G. R. González Toledo, Raquel Gabriel, Ana Golpe Díaz, M. Grau Solá, G. Guardia, Andrea Horta‐Barba, Daniel Idoate Calderón, Jon Infante, Carmen M. Labandeira, M. A. Labrador, Francisco Agramunt Lacruz, M. Lage Castro, S. Lastres Gómez
Abstract
Abstract Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients ( N = 507; p = 0.686) or in the control group ( N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R 2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.