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Parkinson's disease (PD) is a chronic neurodegenerative disorder that has a major impact on health and longevity in Eastern countries. Studies investigating health-related quality of life (HRQoL) in Eastern European and Asian countries are scarce. The objective of this cross-sectional survey was to assess HRQoL in Russian patients with PD and identify its social and clinical determinants. The study included 100 outpatients with idiopathic PD and 100 controls. Patients were consecutively recruited from the neurological department of the Russian Medical State University in Moscow between October 2004 and December 2005. Regional healthy controls were matched for age and sex. The evaluation of HRQoL was performed using the EuroQol instrument (EQ-5D and EQ VAS). Disease severity was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS). Multivariate regression analyses were used to identify independent determinants of HRQoL. HRQoL was more notably decreased in PD patients than in controls (98% versus 74% of individuals with moderate or severe problems in at least one dimension of the EQ-5D (p < 0.001), respectively). As compared to patients, the controls reported a higher mean EQ VAS score (74.0 +/- 16.0 versus 47.7 +/- 16.7, p < 0.001). Social and clinical determinants of HRQoL were age, disease severity, dystonia, depression, dementia and social support. While the HRQoL of patients with PD in Western countries is predominately affected by clinical parameters, social factors play an important role in Eastern countries. Our data should be considered in the development of national healthcare programs that seek to provide better social services support for patients with PD., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Background: The economic burden associated with Parkinson's disease (PD) is increasing as the worldwide population ages. While cost-of-illness studies for PD from developed countries have recently been published, data for Eastern Europe and Asia are still lacking., Objective: To prospectively evaluate direct and indirect costs in a cohort of Russian patients with PD in order to identify cost-driving factors., Methods and Patients: We recruited 100 patients with idiopathic PD who visited the outpatient department for movement disorders of the Russian Medical State University in Moscow between October 2004 and December 2005. The Unified Parkinson's Disease Rating Scale was used to evaluate clinical status. Economic data were collected in a 'bottom-up' approach and evaluated from the societal perspective. Indirect costs were estimated using a human capital approach. Russian currency was converted into euro, year 2005 values, using the purchasing power parity. All costs were then inflated to euro, year 2008 values, using the Medical Care Component of the Consumer Price Index. Independent cost predictors were identified by means of multivariate regression analyses., Results: From the societal perspective, total costs per patient over 6 months amounted to euro2620 (95% CI 2050, 3200), with direct costs accounting for 67% and indirect costs for 33% of the total. Patients' expenditures accounted for 43% of their private income. The primary burden on patients was due to informal care and drugs. Only 10% of home care was provided by the formal service sector. Costs for the nation are estimated at euro1.1 billion per year., Conclusion: The economic burden of PD in Russia is considerable, especially when taking into account low private incomes. Further development of a formal care system and better reimbursement systems for drugs are necessary in Russia.