Quality of life in a German cohort of Parkinson’s patients assessed with three different measures
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Parkinson’s disease (PD) is characterized by severe motor and non-motor symptoms reducing patients’ quality of life (QoL). Instruments have been well established for QoL assessments in PD, including the EuroQol (EQ-5D), the Parkinson’s disease questionnaire (PDQ-39), or rather uncommon, like the WHOQOL-100. So far, the impact of variables has been investigated for each of these measures separately in different study populations, limiting the comparability of the results. Thus, this study compared the EQ-5D, PDQ-39, and the WHOQOL-100 (with its short-form WHOQOL-BREF) in the same study population.
Seventy-five PD outpatients were assessed in a prospective study, including disease severity according to Hoehn and Yahr stage (HY) and Unified Parkinson Disease Rating Scale (UPDRS). The Geriatric Depression Scale (GDS-15) screened for depression.
Decreased QoL was found with all three instruments. In multivariate models, sex and treatment complications had an impact on QoL according to all three measures, while duration of PD and HY was not associated with QoL in any of them. Depression was relevant for the WHOQOL-100/WHOQOL-BREF and the PDQ-39, but not for the EQ-5D. The total variances explained by the WHOQOL-100, WHOQOL-BREF, PDQ-39, and the EQ-5D were 0.27, 0.34, 0.70, and 0.50, respectively.
The associations between clinical aspects of PD and QoL vary substantially among all three measures. Importantly, depression as a frequent comorbidity in PD is underestimated by the EQ-5D, but not by the PDQ-39 and the WHOQOL-100/WHOQOL-BREF. In turn, motor impairments are underestimated by the latter and associated strongest with QoL in the EQ-5D.
KeywordsQuality of life Parkinson’s disease Cohort study WHOQOL-100 DEMPARK/LANDSCAPE study
Data were generated within the LANDSCAPE study (Representatives of the participating centers are: K. Reetz, Department of Neurology, RWTH Aachen University, Aachen; JARA—Translational Brain Medicine, Jülich and Aachen; A. Spottke, Department of Neurology, University of Bonn, and German Center for Neurodegenerative Diseases, Bonn; Department of Psychiatry, University of Bonn, Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn; (A) Storch, Department of Neurology, University Medical Center Rostock; S. Baudrexel, Department of Neurology, Goethe University, Frankfurt/Main; (B) Mollenhauer, Paracelsus-Elena-Klinik, Kassel; Institute of Neuropathology, University Medical Center Goettingen, Goettingen; D. Berg, Department of Neurology, UKSH Campus Kiel, Kiel; I. Liepelt, Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tuebingen, and German Center for Neurodegenerative Diseases, Tuebingen; J. Kassubek, Department of Neurology, University of Ulm; E. Kalbe, Department of Medical Psychology, University Clinic Cologne; H.U. Wittchen, Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden). The LANDSCAPE study is part of the Competence Network Degenerative Dementias (KNDD) which was funded by the German Federal Ministry of Education and Research (project number 01GI1008C).
Compliance with ethical standards
Conflicts of interest
All authors declare that they have no conflicts of interests.
The DEMPARK/LANDSCAPE study was approved by the Ethics Committee of Philipps University of Marburg (approval numbers 178/07 and 25/11) and, subsequently, by the local ethics committees of the participating centers. Written informed consent was obtained from all the participants before study entry.
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