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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; R2 = 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.
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1 CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain (GRID:grid.411066.4) (ISNI:0000 0004 1771 0279)
2 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.411066.4)
3 Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain (GRID:grid.414816.e) (ISNI:0000 0004 1773 7922); CIBERNED (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas), Álava, Spain (GRID:grid.418264.d) (ISNI:0000 0004 1762 4012)
4 Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain (GRID:grid.414875.b) (ISNI:0000 0004 1794 4956)
5 Neurología, Clínica del Pilar, Barcelona, Spain (GRID:grid.414875.b)
6 Hospital Clínic de Barcelona, Barcelona, Spain (GRID:grid.410458.c) (ISNI:0000 0000 9635 9413)
7 Centro Neurológico Oms 42, Palma de Mallorca, Spain (GRID:grid.410458.c)
8 Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain (GRID:grid.410458.c)
9 Hospital Universitario Son Espases, Palma de Mallorca, Spain (GRID:grid.411164.7) (ISNI:0000 0004 1796 5984)
10 Hospital Universitario Vall d´Hebron, Barcelona, Spain (GRID:grid.411083.f) (ISNI:0000 0001 0675 8654)
11 Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain (GRID:grid.411083.f)
12 Hospital Universitario La Princesa, Madrid, Spain (GRID:grid.411251.2) (ISNI:0000 0004 1767 647X)
13 CIBERNED (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas), Álava, Spain (GRID:grid.418264.d) (ISNI:0000 0004 1762 4012); Hospital Universitario Marqués de Valdecilla, Santander, Spain (GRID:grid.411325.0) (ISNI:0000 0001 0627 4262)
14 Consorci Sanitari Integral, Hospital General de L´Hospitalet, L´Hospitalet de Llobregat, Barcelona, Spain (GRID:grid.411325.0)
15 Hospital Universitario Clínico San Carlos, Madrid, Spain (GRID:grid.411068.a) (ISNI:0000 0001 0671 5785)
16 Hospital Da Costa, Lugo, Spain (GRID:grid.411068.a)
17 Hospital del Mar, Barcelona, Spain (GRID:grid.411142.3) (ISNI:0000 0004 1767 8811)
18 Hospital Universitario Virgen Macarena, Sevilla, Spain (GRID:grid.411375.5) (ISNI:0000 0004 1768 164X)
19 Hospital Infanta Sofía, Madrid, Spain (GRID:grid.414758.b) (ISNI:0000 0004 1759 6533)
20 Institut d’Assistència Sanitària (IAS) - Institut Català de la Salut, Girona, Spain (GRID:grid.425907.d) (ISNI:0000 0004 1762 1460)
21 Hospital General Universitario de Elche, Elche, Spain (GRID:grid.411093.e) (ISNI:0000 0004 0399 7977)
22 Fundación Hospital de Alcorcón, Madrid, Spain (GRID:grid.411316.0) (ISNI:0000 0004 1767 1089)
23 Hospital de Tortosa Verge de la Cinta (HTVC), Tarragona, Spain (GRID:grid.490132.d)
24 Complejo Asistencial Universitario de Burgos, Burgos, Spain (GRID:grid.459669.1) (ISNI:0000 0004 1771 1036)
25 Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain (GRID:grid.411220.4) (ISNI:0000 0000 9826 9219)
26 Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain (GRID:grid.411347.4) (ISNI:0000 0000 9248 5770)
27 Hospital Universitario Puerta de Hierro, Madrid, Spain (GRID:grid.73221.35) (ISNI:0000 0004 1767 8416)
28 Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain (GRID:grid.411855.c) (ISNI:0000 0004 1757 0405)
29 Complejo Hospitalario de Toledo, Toledo, Spain (GRID:grid.418888.5) (ISNI:0000 0004 1766 1075)
30 Complejo Hospitalario de Navarra, Pamplona, Spain (GRID:grid.497559.3) (ISNI:0000 0000 9472 5109)
31 CIBERNED (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas), Álava, Spain (GRID:grid.418264.d) (ISNI:0000 0004 1762 4012); Hospital de Sant Pau, Barcelona, Spain (GRID:grid.413396.a) (ISNI:0000 0004 1768 8905)
32 Hospital Universitario Central de Asturias, Oviedo, Spain (GRID:grid.411052.3) (ISNI:0000 0001 2176 9028)
33 Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain (GRID:grid.411052.3)
34 Hospital Universitario Donostia, San Sebastián, Spain (GRID:grid.414651.3) (ISNI:0000 0000 9920 5292)
35 Hospital Arnau de Vilanova, Valencia, Spain (GRID:grid.413937.b) (ISNI:0000 0004 1770 9606)
36 Hospital Ruber Internacional, Madrid, Spain (GRID:grid.413297.a) (ISNI:0000 0004 1768 8622)
37 Hospital Universitario de Cabueñes, Gijón, Spain (GRID:grid.411083.f)
38 Hospital Rey Juan Carlos, Madrid, Madrid, Spain (GRID:grid.459654.f)
39 Complejo Hospitalario Universitario de Orense (CHUO), Orense, Spain (GRID:grid.418883.e) (ISNI:0000 0000 9242 242X)
40 Univeristy of Pennsylvania, Pennsylvania, USA (GRID:grid.25879.31) (ISNI:0000 0004 1936 8972)
41 CIBERNED (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas), Álava, Spain (GRID:grid.418264.d) (ISNI:0000 0004 1762 4012)
42 Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain (GRID:grid.414816.e) (ISNI:0000 0004 1773 7922)
43 Hospital Universitario Lucus Augusti (HULA), Lugo, Spain (GRID:grid.414792.d) (ISNI:0000 0004 0579 2350)
44 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.414875.b)
45 Hospital de Sant Pau, Barcelona, Spain (GRID:grid.413396.a) (ISNI:0000 0004 1768 8905)
46 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.410458.c)
47 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.459669.1)
48 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.425907.d)
49 Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain (GRID:grid.411251.2)
50 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.411220.4)
51 Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain (GRID:grid.411220.4)
52 Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain (GRID:grid.413396.a)
53 Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain (GRID:grid.497559.3)
54 Hospital General Juan Cardona, A Coruña, Spain (GRID:grid.497559.3)
55 Clínica Universidad de Navarra, Pamplona, Spain (GRID:grid.411730.0) (ISNI:0000 0001 2191 685X)
56 Hospital Da Costa, Lugo, Spain (GRID:grid.410458.c)
57 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.418888.5)
58 Hospital General Juan Cardona, A Coruña, Spain (GRID:grid.418888.5)
59 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.413396.a)
60 Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain (GRID:grid.411375.5)
61 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.411251.2)
62 CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain (GRID:grid.414816.e)
63 Hospital Universitario Marqués de Valdecilla, Santander, Spain (GRID:grid.411325.0) (ISNI:0000 0001 0627 4262)