Quality of life and treatment profile of Parkinson's disease patients with long-term duration

Objective To investigate the quality of life and its related factors in Parkinson's disease (PD) patients with long-term duration. Methods The quality of life in 112 PD patients with long-term disease duration (duration≥10 years) was investigated and analyzed. The quality of life in PD patients was measured with the 39-Item Parkinson's Disease Questionnaire (PDQ-39). The effects of age, age of onset, disease duration, motor symptoms, non-motor symptoms, dyskinesia and treatment on the long-term life quality of PD patients were evaluated. Results The mean Unified Parkinson's Disease Rating Scale part Ⅲ (UPDRS Ⅲ) score was 35.8±19.0, and mean PDQ-39 score was 47.5±30.7 in PD patients with 10 years of disease duration and beyond. However, the cases with Hoehn-Yahr stage ≥3.0 accounted for 67.0%(75/112)in the total sample. The independent risk factors of PDQ-39 score included UPDRS Ⅲ score (r=0.272, P=0.007), Hoehn-Yahr stage (r=0.351, P=0.000), and Hamilton Anxiety Scale (r=0.358, P=0.000). Age (r=0.228, P=0.002), age of onset (r=0.207, P=0.027), and motor fluctuations (r=0.282, P=0.002)were three key associated factors for UPDRS Ⅲ score and Hoehn-Yahr stage.In early onset PD, the initial maximum dose of levodopa was positively correlated with worse long-term motor function (r=0.990, P=0.000). The negative correlation was observed between the initial maximum dose of levodopa and long-term motor function in late onset PD (r=-0.480, P=0.044). Conclusions The long-term (duration≥10 years) quality of life in PD patients was determined by the management of motor symptom and the treatment strategies in early stage. In early onset PD patients, delaying or reducing the use of levodopa is needed to prevent dyskinesia. To ensure a better quality of life, higher levodopa dosage should be applied in the late onset PD patients. Key words: Parkinson disease; Quality of life; Sickness impact profile; Questionnaires; Levodopa