Tuesday, November 22, 2022

Parkinson’s Quality Of Life

Correlations Of Clinical Scores With Pdq

Parkinson’s Disease: Maintain Quality of Life with Physical Therapy

The PDQ-39 summary index correlated significantly and positively with depression as measured by the BDI score and negatively with disability as measured by the Schwab and England scale . Significant correlations were also obtained with disease severity as measured by the Hoehn and Yahr scale , the UPDRS motor subscore of axial features , the total UPDRS motor score , and the MMSE . Correlations with duration of disease and age were not significant , and akinesia score and socioeconomic groups just failed to correlate significantly with QoL.

Icipants And Data Collection

In 2013, a prospective observational internet-based study was designed to identify modifiable lifestyle variables associated with the accumulation of patient-reported symptoms over time. The data presented here are a cross-sectional analysis of baseline data from individuals with a self-reported diagnosis of idiopathic PD. The study was approved the Bastyr University IRB and listed on ClinicalTrials.gov . All individuals confirmed they read and understood the participant information sheet prior to study participation. Due to the nature of this being an online survey, the IRB issued a Waiver of Documentation of Informed Consent. All study participants included in this analysis reviewed the Participant Information Sheet and provided consent via the online survey. Study data were collected and managed using REDCap electronic data capture tools hosted at Bastyr University,. REDCap is a secure, web-based software platform designed to support data capture for research studies, providing: an intuitive interface for validated data capture audit trails for tracking data manipulation and export procedures automated export procedures for seamless data downloads to common statistical packages and procedures for data integration and interoperability with external sources.

Evaluation Of Cognitive Functions And Depression

Scores of QoL are usually supplemented by a study of cognitive function and depression, since these factors significantly affect the sense of quality of life, as well as an important context for the interpretation of test results QoL. Severe cognitive impairment and depressive symptoms may be a contraindication to test PRO. Scoring QoL in patients with PD, especially when it is done for scientific purposes, requires the measurement of the functional status and fatigue, because in addition to depression and cognitive impairment, they are the most important determinants of QoL in patients with PD. Following, a review of the most commonly used questionnaires to assess the emotional and cognitive functions is made.

According to different authors, cognitive dysfunctions are observed in 40 – 65% of patients with PD. In preliminary diagnosis of these disorders, the most often used tests are: the Benton test, Mini Mental State Examination , Clock Drawing Test, Rosenbaum vision screening test , Wechsler test .

The specific neuropsychological tests commonly used are: Controlled Oral Word Association Test , California Verbal Learning Test , Digit Symbol Modality Task , Delis-Kaplan Executive Function System , Paced Auditory Serial Addition .

Depression in PD is fairly well understood, its prevalence is estimated in 40 to 60% of the patients .

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Quality Of Life In Parkinson`s Disease

Quality of Life is a multi-dimensional construct, which consists of at least three broad domains: physical, mental and social. In the field of medicine, researchers and physicians have often used health-related quality of life concept, which specifically focuses on the impact of an illness and/or treatment on patients perception of their status of health and on subjective well-being or satisfaction with life . We have described the Quality of Life of post-stroke patients and their caregivers in our first report , Quality of Life in Multiple Sclerosis and QoL in Alzheimer Disease .

Parkinson`s Disease can cause a variety of symptoms. Early in the course of the disease, the most obvious symptoms are movement-related, including shaking, rigidity, slowness of movement and difficulty with walking and gait. Later, cognitive and behavioural problems may arise, with dementia commonly occurring in the advanced stages of the disease. Other symptoms including sleep and emotional problems, depression, difficulties in coordination and speech, severe fatigue, problems with balance and pain will have an impact on the patient`s QoL . We must also take into account complications caused by treatment with levodopa, like dyskinesias, dystonias, and fluctuations.

Data Extraction And Quality Assessment

Improving Quality of Life for Those with Parkinsons Disease

Participant and study information, such as first author, publication year, sampling method, QOL measures, number of PD patients and controls, illness duration, and QOL scores, was extracted. For studies reporting QOL by a patient subgroup , overall QOL was calculated by combining the QOL subgroup scores using a formula. Study quality was independently assessed by the same two researchers using the Newcastle-Ottawa Scale in three domains: selection, comparability and exposure., The NOS total score was calculated by summing up all item scores.

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Impact Of Clinical Features On Pdq

Patients with high levels of depression , a mini mental state score of 24 or less ,postural instability on examination , and a history of falls or of gait difficulties had significantly worse PDQ-39 summary index scores than patients without these features . QoL scores of patients with the akinetic rigid subtype of Parkinson’s disease were also worse than those with tremor dominant disease. This difference could not be explained by older age or longer disease duration, as age and disease duration were similar between those with tremor dominant and those with akinetic rigid Parkinson’s disease. The difference of QoL scores between those with and those without a history of hallucinations just failed to reach significance . No difference in PDQ-39 scores was found between men and women and between patients with or without a poor initial or current response to antiparkinsonian medication. A history of dyskinesias or fluctuations, incontinence, orthostatic symptoms, insomnia, pain, speech or swallowing impairment, a family history of Parkinson’s disease, and symptom at onset had no significant impact on QoL scores. There was also no difference between those who were unemployed or had retired early due to the disease and those who were not, those with disease onset before or after the age of 50, and those with current age older than 60 or 70.

Clinical features associated with significantly impaired quality of life scores

Parkinsons Disease And Quality Of Life A Patients Perspective

Abstract:
Overview
Keywords

Parkinsons disease, quality of life, patients perception, shared decision-making

Article:

Parkinsons disease is a journey and like all journeys it is not about the destination, but about how you get there. Quality of life with PD varies depending on where you live and who you are. It is all very well to say, as this article says later, that attitude is everything, but if you are stuck in a fine art auction room with uncontrollable tremor, a good attitude will not help you. Although stated lightly here, this point is a serious one QoL varies from country to country and from situation to situation to an alarming degree. These issues are too complex to tackle in a paper such as this they comprise a much wider socioeconomic problem which none of us can materially affect so instead we should concentrate on issues where we can and do have an influence.

Symptoms and Quality of Life Most readers of this article will be aware of the symptoms of PD, and a simple account of my personal symptoms would provide nothing new to this supplement. Here are some facts that may be typical of many patients with PD :

Neurologists see and hear these things every day and patients experience them frequently. Similarly, the psychological effect that the diagnosis of PD has in the early years, the more recent lack of sleep, the inability to organise oneself, and periods of obsessive behaviour, are all real problems that many people with PD encounter.

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Can Parkinsons Disease Be Detected Through Facial Expressions

US researchers have used an artificial intelligence tool to detect Parkinsons through the analysis of facial expressions. The team collected 1,812 videos featuring 604 people 543 of these participants didnt have Parkinsons while 61 did. They were recorded making three facial expressions disgust, surprise and a smile followed by a neutral expression. Measuring these in terms of micro-expressions, the AI tool found that people with Parkinsons had fewer facial muscle movements than those without. The researchers used this information to train a machine learning tool to distinguish between people with and without the condition. It was able to identify Parkinsons in individuals with 95.6% accuracy. Reflecting on the tools potential to be an important digital biomarker for the condition, the team wrote: An algorithms ability to analyse the subtle characteristics of facial expressions, often invisible to a naked eye, adds significant new information to a neurologist.

Neuropsychological Tests And The Classification Of Pd

Parkinson’s Disease Treatment Restores Quality of Life

Patients who were taking regular anti-parkinsonian medications took the cognitive assessment. Global cognitive abilities were assessed in all patients using the MMSE . A comprehensive battery of neuropsychological tests was used to examine five specific cognitive domains. The Symbol Digit Modalities Test and Trail Making Test A were used to evaluate attention and working memory. The Stroop Color-Word Test and Trail Making Test B were used to evaluate executive function. The Boston Naming Test and Animal Fluency Test were used to evaluate language. The Auditory Verbal Learning Test and delayed recall of the Rey-Osterrieth Complex Figure Test were used to evaluate memory. The Clock Drawing Test and copy task of the Rey-Osterrieth Complex Figure test were used to evaluate visuospatial function. The normative data and instructions for all the above neuropsychological tests are shown in Supplementary Table 1.

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Research And Practice Implications

In conjunction with previous research, the findings from this study have implications for research and practice with PD caregivers. Given the robust associations between PD symptoms and caregiver QOL, investigations into identifying caregivers at risk for poor QOL based on particular symptoms profiles of individuals with PD and providing them with evidence-based support would be extremely important. Such research should explore the role of mobility and non-motor symptoms, as these were the primary predictors of reduced caregiver QOL. When these symptoms are present, clinicians can provide caregivers with referrals to appropriate support groups and, if appropriate and accessible, respite care . It is critical to identify caregivers providing care to individuals with PD with particularly mobility difficulties and greater non-motor symptoms, as caregivers may experience even worse QOL as PD progresses.

Sonic Hedgehog Protein Could Impact Parkinsons Disease Dyskinesia

Dyskinesia is often caused by extended use of the common Parkinsons medication levodopa and can be debilitating for those with the condition. Now, researchers in the US may have found a way to suppress these involuntary movements through a protein called sonic hedgehog. To conduct their study, the team administered levodopa and sonic hedgehog agonists to rodent and non-human primate models of the condition. The results revealed that dopamine neurons use the protein to communicate with other neurons thought to play a role in levodopa-induced dyskinesia. Increased signalling of sonic hedgehog pathways was found to reduce this dyskinesia providing novel insight into its formation and a potential therapeutic solution. What we find, wrote corresponding study author Professor Andreas Kottmann, is that in several animal models, by replacing dopamine together with agonists that mimic the effects of sonic hedgehog, these dyskinesias can be very much suppressed.

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Living A Full Life With Parkinson’s

Page contents

  • Using the Internet to your advantage
  • Living with Parkinsons can affect the way you carry out a broad range of everyday activities, from working and driving, to simply eating and brushing your teeth. But by making some small changes in your lifestyle and also in your approach to activities, you can maintain independence and continue many of your usual routines. It is possible to maintain a good quality of life, simply by embracing change.

    There is no doubt that a positive outlook, along with determination to overcome obstacles and focus on what you can do, will help you adapt to living with Parkinsons and, given time and an optimistic attitude, you will be able to continue to pursue the activities and relationships that make your life enjoyable and meaningful.

    Maintaining & Improving Quality Of Life While Living With Pd

    PPT

    The motor and non-motor symptoms of PD can contribute to changes in many aspects of ability and lifestyle. The goal of Parkinsons treatment is to reduce symptoms and maintain functioning for as long as possible. Diminished capacity to function normally and independently can be challenging or even devastating for those with PD. Individuals with Parkinsons can face a multitude of challenges to their quality of life throughout the disease. Areas that may be impacted include: employment, driving, traveling, dental health, falls, hospitalization, and financial issues.

    This page also contains information on prescription assistance, elder law, and late stage PD. Parkinsons disease is different for every individual, but you are not alone. Form your multidisciplinary team early your team could include: your neurologist, primary physician, family caregiver, mental health professional, attorney, pharmacist, social worker, and others. Please call us toll-free at 1-866-903-PARK if you would like to discuss specific resources in your area.

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    Helpful Hints About The Home

    There are many tips and tricks you can put into place around your home that will help you in your everyday life. Simply adjusting the layout of your kitchen can make food preparation much safer and easier, or perhaps changing the type of sole you have on your shoe will help to prevent falls.

    To see a wide range of suggestions to help with activities from dressing to driving, and movement to memory see Helpful hints.

    Using The Internet To Your Advantage

    The Internet is an invaluable tool and is brilliant for finding information on Parkinsons. Search engines such as Google make it possible to target particular topics of interest within seconds, 24 hours every day of the year. However, it needs to be used with some discretion, as not everything posted on the Internet can be trusted and you need to be vigilant. By following a few simple rules you can certainly benefit from the wealth of information available to you. If you have difficulty using a computer, then there are various aids which can help so dont be put off. The Internet can also be a useful tool for doing things that might otherwise take more time, for example booking holidays, or making purchases online.

    See also Using computers and the Internet.

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    Looking After Your Feet

    Our feet work incredibly hard so it is important to look after them. Any foot problems left untreated may become painful, reduce mobility and may make falls more likely. People with Parkinsons may be particularly susceptible to certain foot problems and may also find it harder to care for their feet.

    For information on potential foot problems and ways to treat them, as well as practical advice for looking after your feet, see Footcare.

    Support Our Spring Research Campaign

    Parkinson’s Disease: Maintain Quality of Life with Physical Therapy

    More and more people apply for funding every year. With your help, we can fund more research that can improve quality of life for people living with Parkinsons today. Join us now through the end of Parkinsons Awareness Month to play an essential role in this research by supporting our Quality of Life Research Fund. to learn more about how your contributions help our Science Advisory Board say yes to more promising research projects that change peoples lives.

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    Correlation Analysis Of Clinical Characteristics And Qol In Pd

    Correlation analysis between clinical characteristics and PDQ-39 SI was performed in all PD patients . GDS score, UPDRS-III score, disease duration, LED, ESS and RBDSQ score were positively associated with PDQ-39 SI, while education and SSST-12 score were negatively correlated with PDQ-39 SI.

    Table 3. Correlation analysis of clinical characteristics and PDQ-39 SI in PD-NC, PD-MCI and PDD patients.

    Then, we explored the impact of clinical characteristics on QoL in PD patients with different cognitive states. In PD-NC and PD-MCI patients, GDS score, UPDRS-III score, disease duration, LED, ESS and RBDSQ score were positively correlated with PDQ-39 SI. In PDD patients, GDS score, UPDRS-III score, disease duration, ESS, LED and RBDSQ score were positively correlated with PDQ-39 SI, while education was negatively correlated with PDQ-39 SI.

    Emotional Psychological And Intellectual Wellbeing

    It is important to look after your emotional, psychological and intellectual wellbeing, as well as manage physical symptoms.

    We all need to look after ourselves, but if you have Parkinsons this is particularly important as this can not only enhance your quality of life but it may also slow down the progression of some symptoms. There are many simple ways in which you can enhance your general wellbeing as outlined below.

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    Quality Of Life And Caregivers’ Burden Of Parkinson’s Disease

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    Scoring And Statistical Analysis

    Quality of Life as Assessed by Means of the Parkinson

    Summary scores as well as the subdimensions of the PDQ-39 were calculated according to the scoring algorithm. The akinesia score of the UPDRS was calculated as the sum of item 19 and 23 to 26 of the UPDRS for both sides, the score of axial features from items 27 to 30, and the tremor score from items 20 and 21 for both sides. The tremor dominant subtype of Parkinson’s disease was defined as patients with a ratio of tremor to bradykinesia score of 0.5 or more, and the akinetic rigid subtype as patients with a ratio of< 0.5. Socioeconomic groups were determined according to the classification of occupations and coding index with socioeconomic group 1 representing the highest and group 5 the lowest socioeconomic class.

    Mean values were compared by the Mann-Whitney test, and Spearman rank correlation coefficients were calculated to assess the direction and magnitude of association between variables. Stepwise multiple regression analysis was used to determine the factors that best accounted for variance in QoL scores. Due to the number of different comparisons, statistical significance was only accepted at p< 0.005.

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