Clinical Determinants of Health-related Quality of Life in Mexican Patients with Parkinson's Disease

Background and Aims. Parkinson's disease (PD) is the second most common chronic neurodegenerative disorder. PD is clinically characterized by a constellation of motor and nonmotor symptoms that may have a direct effect on daily activities as well as in the quality of life of the patient. Identifying the symptoms more closely associated with a poor quality of life is central on improving the medical care of the patient. We undertook this study to identify and describe the clinical and demographic factors that predict health-related quality of life among Mexican patients with PD. Methods. One hundred seventy-seven patients with Parkinson's disease were included. Patients were evaluated using the following clinimetric instruments: motor subscale of the Unified Parkinson's disease rating scale, Hoehn and Yahr stage, Non-motor Symptoms Questionnaire, Parkinson's disease Questionnaire (PDQ-39) and the Mini Mental Status Examination. Results. Multivariate analysis showed that the main factors associated with a poor quality of life were motor impairment (beta = 0.27, p <0.001) and the number of nonmotor symptoms (beta = 2.17, p <0.001). The main nonmotor domains impacting on the quality of life were depression/anxiety (beta = 6.36, p <0.001), cardiovascular (beta = 5.39, p = 0.001), memory (beta = 4.64, p <0.001) and miscellaneous (beta = 3.15, p = 0.001). Conclusions. Both motor and mainly nonmotor symptoms are negatively associated with health-related quality of life in patients with PD and should be appropriately attended in order to improve patient care. (C) 2013 IMSS. Published by Elsevier Inc.