Search

Background: The study aimed to appraise the health-related quality of life (HRQoL) measured by the five-level EuroQol-5 dimensions (EQ-5D-5L) in amyotrophic lateral sclerosis (ALS), and to explore the associations between non-motor symptoms (mood changes, cognitive disturbances and sleep disturbances)., Methods: EQ-5D-5L descriptive scores were converted into a single aggregated "health utility" score. A calibrated visual analog scale (EQ-VAS) was used for self-rating of current health status. Multiple logistic regression analysis was used to explore the factors associated with HRQoL., Results: Among the 547 enrolled ALS patients who were assessed using EQ-5D-5L, the highest frequency of reported problems was with usual activities (76.7%), followed by self-care (68.8%) and anxiety/depression (62.0%). The median health utility score was 0.78 and the median EQ-VAS score was 70. Clinical factors corresponding to differences in the EQ-5D-5L health utility score included age of onset, onset region, the ALS Functional Rating Scale-Revised (ALSFRS-R) score, and King's College stages. Patients with depression, anxiety, and poor sleep had lower health utility scores. Patients with excessive daytime sleepiness and rapid eye movement sleep behavior disorder had lower EQ-VAS scores. Multivariate logistic analysis indicated that ALSFRS-R scores, depression, and anxiety were associated with health utility scores. After adjusting other parameters, ALSFRS-R score, stages, and depression were significantly associated with EQ-VAS scores (P < 0.05)., Conclusion: This study examined HRQoL in ALS patients using the Chinese version of the EQ-5D-5L scale across different stages of the disease. We found that HRQoL is related to disease severity and to mood disturbances. Management of non-motor symptoms may help improve HRQoL in ALS patients., (© 2021. The Author(s).)

Background: Cognitive impairment is an important and common symptom in patients with multiple system atrophy (MSA)., Objective: The objective of the study was to explore the potential relationships among frontal lobe function, behavioral changes and quality of life (QoL) in patients with MSA., Methods: A total of 203 MSA patients were enrolled and evaluated using the Frontal Assessment Battery (FAB), the Frontal Behavioral Inventory (FBI) and the Parkinson's disease Questionnaire-39 item version (PDQ-39). Seventy-eight age-, sex-, and education-matched healthy controls were recruited to complete the FAB., Results: Among MSA patients, those with frontal lobe dysfunction were older (P = 0.005), had older age of onset (P = 0.002), lower educational level (P <  0.001), higher scores in the PDQ-39 domains of mobility (P = 0.042), ADL (P = 0.020), cognition (P <  0.001) and communication compared to those with normal frontal lobe function. The most common frontal behavioral changes were logopenia followed by apathy and inflexibility. The severity of frontal behavioral changes was associated with MSA subtype (P = 0.015), disease severity (Unified Multiple System Atrophy Rating Scale-I (UMSARS-I), UMSARS-II, UMSARS-IV, and total UMSARS scores) (P <  0.001), orthostatic hypotension (P = 0.022), severity of depressive symptoms and total score on the PDQ-39 (P <  0.001). Binary logistic regression showed that the determinants of poor QoL in patients with MSA were disease severity (UMSARS-I and total UMSARS scores) (P <  0.05), depression (P = 0.013) and total FBI score (P = 0.003)., Conclusions: Frontal behavioral changes were potential determinants of poor QoL in MSA, in addition to the disease severity and depressive symptoms. Early discovery and management of frontal behavioral changes in addition to motor and depressive symptoms will help to improve the QoL of MSA patients.

Background: The differences in non-motor symptoms (NMS) and quality of life (QOL) between MSA patients with different subtypes remain unknown, so do the determinants of poor QOL in both subtypes., Methods: A total of 172 MSA patients were enrolled in the study. NMS of patients with MSA were assessed using the non-motor symptoms scale (NMSS) and Parkinson's Disease Questionnaire-39 item version (PDQ-39) was used to evaluate the QOL of patients with MSA., Results: The most prevalent NMS domain was urinary (91.3%) in both subtypes. The mood/apathy domain was more severe in MSA-P than MSA-C patients (P < 0.05). Drooling, constipation, and pain symptoms were more prevalent and severe in the MSA-P patients compared to the MSA-C patients (P < 0.05). We found that the MSA-C patients had a higher score of mobility than the MSA-P patients (P = 0.002); However, the MSA-P patients had a higher score of bodily discomfort than the MSA-C patients (P = 0.036). There were close correlations between NMS and PDQ-39 in both subtypes. Disease severity, cardiovascular symptoms, sleep/fatigue symptoms and gastrointestinal symptoms were determinants of poor QOL in MSA-P patients. While in MSA-C patients, longer disease duration, disease severity and mood/apathy symptoms were determinants of poor QOL., Conclusion: NMS are more severe and prevalent in MSA-P patients, especially for mood/apathy and gastrointestinal symptoms. There is a close relationship between NMS and QOL in both MSA subtypes. Disease severity, longer disease duration and severe NMS are determinants of poor QOL in MSA., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: The determinants of the quality of life (QoL) of patients with Parkinson's disease (PD) in Chinese population remain largely unknown., Methods: A total of 649 PD patients from Southwest China participated in this cross-sectional study. Non-motor Symptoms Scale (NMSS) was used to evaluate the non-motor symptoms (NMS), whereas PD Quality of Life Questionnaire (PDQ-39) was used to assess the QoL of the PD patients. Multiple stepwise regression analysis was conducted to identify the determinants of the QoL., Results: NMS, H-Y stage, female, disease duration, UPDRS III score, single/divorced/widowed, and motor complications accounted for 66.3% of the variables in the multiple regression analysis and were the negative determinants of the QoL. Among these variables, NMS and H-Y stage accounted for 46.7% and 14.5%, respectively. NMS were closely associated with each domain of PDQ-39. Female sex especially predicted poor emotional well-being and bodily discomfort, whereas single/divorced/widowed especially predicted poor stigma and social support of PD patients. Comorbidity, motor complications and rural living predicted poor mobility, activities of daily living and emotional well-being, respectively., Conclusion: Both demographic and disease-specific factors influence the QoL in PD patients. NMS are the strongest independent negative determinant of the overall QoL and closely associated with each domain of PDQ-39. The treatment of NMS may help to improve the QoL of PD patients., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Objective To explore the associated factors for quality of life in patients with progressive supranuclear palsy (PSP). Methods A total of 218 PSP patients were included from January 2012 to December 2019. Demographic and clinical data were collected. The quality of life was evaluated by the 39⁃Item Parkinson's disease Questionnaire (PDQ⁃39). The Progressive Supranuclear Palsy Rating Scale (PSPRS) was used to assess the severity of PSP related motor and non⁃motor symptoms, while the Non⁃Motor Symptoms Scale (NMSS) was used to elevate the non⁃motor symptoms, Hamilton Depression Rating Scale⁃24 (HAMD⁃24), Hamilton Anxiety Rating Scale (HAMA), Lille Apathy Rating Scale (LARS), Frontal Assessment Battery (FAB), and Montreal Cognitive Assessment (MoCA) were used. The Pearson and partial correlation followed by the multiple linear regression were used to explore the correlates of the PDQ⁃39 score. Results Correlation analysis indicated that the PDQ⁃39 score was positively correlated with disease duration (r=0.301, P=0.000), Charlson Comorbidity Index (CCI; r=0.147, P=0.031), levodopa equivalent daily dose (LEDD; r=0.225, P=0.001), and scores for the PSPRS (r=0.551, P=0.000), NMSS (r=0.484, P=0.000), HAMD⁃24 (r=0.515, P=0.000), HAMA (r=0.439, P=0.000) and LARS (r=0.476, P=0.000), but was negatively correlated with scores of FAB (r=⁃0.325, P=0.000) and MoCA (r=⁃0.355, P=0.000). Multiple linear stepwise regression model indicated that the PDQ⁃39 score was significantly associated with female (P=0.021), longer disease duration (P=0.026), higher LEDD (P=0.008), higher PSPRS score (P=0.000), higher NMSS score (P=0.002), higher HAMD⁃24 score (P=0.004), and higher LARS score (P=0.000). Conclusions Female, longer disease duration, higher LEDD, and more severe motor and non⁃motor symptoms contribute to the reduced quality of life in patients with PSP. Our study is beneficial to the clinical management of patients with PSP.