Health-related Quality of Life in Parkinson’s Disease
In general, measures of Parkinson’s disease (PD) symptoms, biomedical markers or survival do not cover every aspect of the disease relevant or important to the patient. Health-related quality of life (HRQoL) is defined as the perception and evaluation by the patient of the impact that the illness and its consequences has had on their life. Therefore, it is a subjective measurement, but one that helps in providing a more rounded picture of the effects of a disease on the patient. Several forms and questionnaires have been developed to measure HRQoL, including generic forms such as the Short-Form 36 Health Survey (SF-36), and disease-specific forms such as the 39-item Parkinson’s Disease Questionnaire (PDQ-39).
HRQoL is reduced in PD patients. In a study that measured HRQoL using the Nottingham Health Profile in 233 PD patients and 100 healthy elderly people, PD patients had lower HRQoL in all measured dimensions (emotional reactions, energy, pain, physical mobility, sleep, social isolation and total score of the Nottingham Health Profile) compared with the healthy elderly people.1
Many factors in PD could impact on HRQoL, such as motor symptoms, non-motor symptoms (NMS), disability, social functioning limitations and drug side-effects. A study showed that a decline in physical mobility was the most important single factor contributing to worsening HRQoL in people with PD during long-term follow-up.2 It also showed that a deterioration in NMS, when taken together, had a greater impact on overall HRQoL than a decrease in physical mobility. In addition, poor HRQoL was predicted by more advanced disease, greater severity of depressive symptoms and presence of insomnia.
Changes in Health-related Quality of Life after Deep Brain Stimulation
Thousands of patients have been treated with deep brain stimulation (DBS) since the first procedure in 1993, and clinical results on motor symptoms and motor complications have been reported in a large number of publications.3 In the last few years, there have been three randomised studies that used measurements of HRQoL as important endpoints.4–6
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