Correlation Analysis Of Parkinson’s Disease Symptoms And Their Impact On Patients’ Lives

Objective:To explore the occurrence of motor symptoms and various non-motor symptoms and related influencing factors of Parkinson’s disease patients,and to analyze the influencing factors of quality of life and daily living ability of Parkinson’s disease patients,so as to provide reference for the further study,diagnosis,treatment and management of Parkinson’s disease.Methods:A total of 155 patients with Parkinson’s disease who visited the Department of Neurology of our hospital from June 2016 to January 2020 were collected.The general data of all patients were collected.The Hamilton Anxiety and Depression Scale was used to evaluate the anxiety and depression status and degree of the patients.Unified Parkinson disease rating scale to assess the patient’s symptoms and complications,Montreal cognitive assessment scale and scale for assessment of cognitive function in patients with simple mental state examination,14 assess the patient’s level of fatigue,fatigue scale-fort Pittsburgh sleep quality index to evaluate the sleep quality of patients,patients with RBD sleep scale to assess whether there rem sleep behavior disorder,patients with Epworth sleepiness scale to assess whether there is excessive daytime sleepiness,Parkinson’s autonomic nerve symptom scale to assess the patient’s symptoms of autonomic nerve,PDQ-and assess the patient’s quality of life,daily life activities All data were input into Excel,and SPSS23.0software was used for statistical analysis.T-test or rank sum test was used for quantitative data,X~2 test was used for enumeration data,and multivariate Logistic regression was used to analyze the influencing factors of patients’daily living ability.Results:A total of 155 patients with Parkinson’s disease were included in this study,ranging in age from 41 to 89 years old,with an average age of67.82±9.86.Among them,there were 94 male patients(60.6%)and 61 female patients(39.4%),with a male-to-female ratio of 1.54:1.The course of disease ranged from 1 to 23 years,with a median of 6 years and a interquartile interval of(4,9)years.There were 115 cases of motor complications,accounting for74.2%.All patients had combined with non-motor symptoms,among which 3patients(accounting for 1.9%of all patients)had combined with one non-motor symptom.There were 11 patients(7.1%)with two kinds of non-motor symptoms.There were 21 patients with 3 non-motor symptoms,accounting for13.5%;There were 22 patients(14.2%)with 4 kinds of non-motor symptoms.There were 98 patients with 5 or more non-motor symptoms,accounting for 63.2%of all patients.There were 100 patients with cognitive decline,accounting for 64.5%.There were 109 patients with depression,accounting for 70.3%of the total number of patients,including 69 patients with mild depression,accounting for 44.5%;35 patients with moderate depression,accounting for 22.6%;5 cases of severe depression,accounting for 3.2%of the total.There were 93 patients with anxiety,accounting for 60.0%of the total number,among which,49 patients with mild anxiety,accounting for 31.6%;37patients with moderate anxiety,accounting for 23.9%;Severe anxiety was found in 7 patients,accounting for 4.5%.Anxiety and depression comorbidities were87 cases,accounting for 56.1%.There were 151 patients with autonomic nervous symptoms,accounting for 97.42%of the total number.There were 111patients with sleep disorder,accounting for 71.6%of the total number.There were 17 patients with REM sleep behavior disorder,accounting for 11.0%of the total number.There were 53 cases of excessive daytime sleepiness,accounting for 34.2%.Spearman rank correlation analysis showed that UPDRSⅢscore was positively correlated with SCOPA-AUT,HAMA,HAMD,PSQI,FS-14,age,disease course and Hoehn-Yahr Staging,and inversely correlated with MOCA and education background.The tremor group had the lowest UPDRSⅢscore(X~2=7.269,P=0.026),FS-14 score(X~2=6.474,P=0.039),HAMD score(X~2=8.454,P=0.015)and the incidence of daytime excessive sleepiness(X~2=8.469,P=0.014),while the ankyotrosis group had the highest SCOPA-AUT score.According to rank sum test,the scores of UPDRSⅢ,HAMD,SCOPA-AUT,FS-14 and PSQI in the anxious group were higher than those in the non-anxious group.Chi-square test showed that the incidence of motor complications in the anxiety group was higher than that in the non-anxiety group,the incidence of excessive daytime sleepiness in the anxiety group was higher than that in the non-anxiety group,the patients in the middle and late Hoehn-Yahr Staging in the anxiety group were more than those in the non-anxiety group,and the patients with tremor in the anxiety group were more than those in the non-anxiety group.According to rank sum test,the scores of UPDRSⅢ,SCOPA-AUT,FS-14,MOCA,PSQI and HAMA in the depressed group were higher than those in the non-depressed group,and the course of disease in the depressed group was longer than that in the non-depressed group.The chi-square test showed that the depression group had a higher incidence of motor complications and a higher incidence of excessive daytime sleepiness.The rank sum test showed that the scores of UPDRSⅢ,SCOPA-AUT,FS-14,HAMD,HAMA and PSQI in the cognitive impairment group were higher than those in the non-cognitive impairment group.Chi-square test showed that the incidence of excessive daytime sleepiness in the cognitive impairment group was higher than that in the non-cognitive impairment group.By rank sum test,the scores of UPDRSⅢ,SCOPA-AUT,FS-14,HAMA and HAMD in the sleep disorder group were higher than those in the non-sleep disorder group.The chi-square test showed that patients with sleep disorders had a higher incidence of movement and development.Spearman rank correlation analysis showed that the higher the score of FS-14,the higher the scores of UPDRSⅢ,UPDRSⅣ,SCOPA-AUT,HAMA,HAMD,PSQI,and the higher the Hoehn-Yahr Staging.The higher the FS-14 score,the lower the MOCA score.Spearman rank correlation analysis showed that the higher the SCOPA-AUT score was,the higher the scores of UPDRSⅢ,UPDRSⅣ,FS-14,HAMA,HAMD,PSQI,age and disease course were,and the higher the Hoehn-Yahr Staging was.The higher the SCOPA-AUT score,the lower the MOCA score.Spearman rank correlation analysis showed that the higher the score of PDQ-39,the higher the scores of UPDRSⅢ,UPDRSⅣ,SCOPA-AUT,FS-14,HAMA,HAMD,PSQI and ADL,and the higher the Hoehn-Yahr Staging and the longer the course of disease,the higher the score of PDQ-39,the lower the score of MOCA,and the lower the educational background.Multivariate Logistic regression analysis showed that ADL was related to UPDRSⅢ,HAMD and age,and the regression equation was logit(P)=8.678+0.060×age+0.361×UPDRSⅢ+0.087×HAMD.Conclusion:The results of this study suggest that the incidence of motor complications and non-motor symptoms is higher in PD patients.The symptoms of Parkinson’s disease are interrelated with each other.The rank correlation analysis of quality of life indicated that education,course of disease,age of patients,severity of motor symptoms,H-Y stage,motor complications,subtypes of motor symptoms,autonomic nervous dysfunction,cognitive decline,sleep disorders,mood disorders and fatigue were all related to quality of life of patients with PD.The main risk factors of PD patients’daily living ability are age,severity of motor symptoms and depression.To improve PD patients’daily living ability and quality of life,comprehensive management of PD patients’various symptoms should be strengthened.