To Study The Quality Of Life And The Factors Affecting The Quality Of Life Of Patients With Parkinson’s Disease

Objective:To explore the quality of life and the factors affecting the quality of life in patients with Parkinson’s disease.Methods: From April 2021 to February 2023,patients with clinically diagnosed Parkinson’s disease were collected in the outpatient and inpatient department of Dalian Friendship Hospital as research objects.According to the inclusion and exclusion criteria,a total of 13 patients with incomplete and unqualified clinical data were excluded,and 172 subjects were finally included in the study.Age,sex,course of disease,Hoehn-Yahr(H-Y)stage,levodopa equivalent daily dosage(LEDD),Movement Disorders Society Unified Parkinson’s Disease Rating ScaleⅢ(MDS-UPDRSⅢ),Movement Disorders Society Unified Parkinson’s Disease Rating Scale Ⅳ(MDS-UPDRS Ⅳ),Wearing-Off phenomenon-9 items questionnaire(WOQ-9),Montreal cognitive assessment scale(Mo CA),Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),Pittsburgh sleep quality index(PSQI),King’s Parkinson’s disease pain scale(KPPS),Modified Apathy Estimate Scale(MAES),Fatigue Severity Scale(FSS),Scale for Outcomes in Parkinson’s disease for autonomic Symptoms(SCOPA-AUT)and disease economic burden scale of the study subjects were collected.Health related quality of life(HRQo L)was assessed using the 39-item Parkinson’ s disease questionnaire(PDQ-39).Correlation analysis is conducted between quantitative data and PDQ-39.The qualitative data are grouped and the differences of PDQ-39 are compared between groups.Stepwise regression analysis explores which factors affect PDQ-39.The subjects are divided into groups according to PDQ-39median(35 points),and the differences of various factors are compared between groups,and binary Logistic regression analysis is conducted to explore which factors affect HRQo L.Results: The distribution of PDQ-39 in the study cohort is not normal,and the median is 35 points.Spearman correlation analysis is conducted between PDQ-39 and quantitative data.The results show that PDQ-39 is correlated with age(r=0.201,P=0.008)and course of disease(r=0.411,P<0.001),LEDD(r=0.516,P<0.001),MDS-UPDRSⅢ(r=0.537,P<0.001),MDS-UPDRSⅣ(r=0.322,P<0.001),WOQ-9(r=0.284,P<0.001),HAMD(r=0.603,P<0.001),HAMA(r=0.531,P<0.001),PSQI(r=0.496,P<0.001),MAES(r=0.373,P<0.001),FSS(r=0.549,P<0.001),SCOPA-AUT(r=0.498,P<0.001)positive correlation;PDQ-39 and MOCA(r=-0.409,P<0.001)have a negative correlation.Comparing qualitative data between groups,the results show that there is no statistically significant difference in PDQ-39 between the male and female groups(P=0.809);There are statistically significant differences(P<0.001)in PDQ-39 between early and late stage groups,between painless and painless groups,and between groups where the economic burden of disease(i.e.the monthly cost of PD treatment as a percentage of income)is less than 10%,10%-50%,and 50%-100%(P<0.001).Excluding irrelevant variable gender(P=0.809),age,course of disease,H-Y stage,LEDD,MDS-UPDRSⅢ,MDS-UPDRSⅣ,WOQ-9,MOCA,HAMD,HAMA,PSQI,KPPS,MAES,FSS,SCOPA-AUT,and economic burden of disease are included in the stepwise regression analysis.The results show that the R square of the stepwise regression model is 0.691.HAMD(P < 0.001),MDS-UPDRSⅢ(P<0.001),economic burden of disease(P<0.001),FSS(P<0.001)and WOQ-9(P=0.004)are the factors affecting PDQ-39.According to PDQ-39 median(35 points),subjects in this study are divided into PD HRQo L good group(PDQ-39≤35 points)and PD HRQo L poor group(PDQ-39>35points),conducted comparison between two groups.Independent sample T test is used for those with quantitative data consistent with normal distribution(age).Those who dose not fit the normal distribution(course of disease,LEDD,MDS-UPDRSⅢ,MDS-UPDRSⅣ,WOQ-9,MOCA,HAMD,HAMA,PSQI,MAES,FSS,SCOPA-AUT)are tested by the Mann-Whitney U test.In qualitative data,Chi-square test is used for binary variables(gender,H-Y stage and KPPS),and Man-whitney U test is used for Ordered multi-classification variable(economic burden of disease).In addition to sex(P=0.366),age(P=0.001),course of disease(P<0.001),H-Y stage(P<0.001),LEDD(P<0.001),MDS-UPDRSⅢ(P<0.001),MDS-UPDRSⅣ(P<0.001),WOQ-9(P<0.001),MOCA(P<0.001),HAMD(P<0.001),HAMA(P<0.001),PSQI(P<0.001),KPPS(P<0.001),MAES(P<0.001),FSS(P<0.001),SCOPA-AUT(P<0.001),economic burden of disease(P<0.001)are statistically different.Univariate Logistic regression analysis is performed for age,sex,course of disease,H-Y stage,LEDD,MDS-UPDRSⅢ,MDS-UPDRSⅣ,WOQ-9,MOCA,HAMD,HAMA,PSQI,KPPS,MAES,FSS,SCOPA-AUT and economic burden of disease.Excluding gender(P=0.366),16 factors including age(P=0.002),course of disease(P<0.001),H-Y stage(P<0.001),LEDD(P<0.001),MDS-UPDRSⅢ(P<0.001),MDS-UPDRSⅣ(P<0.001),WOQ-9(P<0.001),MOCA(P<0.001),HAMD(P<0.001),HAMA(P<0.001),PSQI(P < 0.001),KPPS(P < 0.001),MAES(P < 0.001),FSS(P < 0.001),SCOPA-AUT(P<0.001),economic burden of disease(P<0.001)are included in multivariate logistic regression analysis and the results show that LEDD,MDS-UPDRSⅢ,FSS and economic burden of disease are risk factors for HRQo L in PD patients(OR>1).Conclusions: HAMD,MDS-UPDRSⅢ,economic burden of disease,FSS,and WOQ-9 are the factors affecting PDQ-39.LEDD,MDS-UPDRSⅢ,FSS and economic burden of disease are risk factors for HRQo L in PD patients.The above mentioned aspects should be emphasized in clinical work to improve the HRQo L of PD patients.