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1.102 FACTORS ASSOCIATED WITH FUNCTIONAL PERFORMANCE IN ELDERLY PEOPLE WITH PARKINSON'S DISEASE
Monday, 12 December 2011 / Parkinsonism and Related Disorders 18S2 (2012) S1–S79
141.7±22.9; (2) The incidence of anxiety in PD patients was 39.8%, and the incidences of mild, moderate and severe anxiety were 28.8%, 10.2% and 0.8%, respectively. The scores of PDQ-39 in PD patients with and without anxiety were 120.5±19.1 vs. 138.8±28.8; (3) The incidences of MCI and dementia in PD patients were 69.5% and 6.3%, respectively. The scores of PDQ-39 in PD patients with and without MCI, with and without dementia were 128.0±23.8 vs. 135.1±22.6, 111.0±15.4 vs.132.2±23.4; (4) The scores of HAMA, HAMD, MoCA and MMSE all have linear correlations with the results of PDQ-39 (p < 0.01). Conclusions: Emotional disorders and cognitive impairment are important non-motor symptoms with high incidences and are the pivotal factors compromising the quality of life in PD patients. 1.100 DEMENTIA, NONMOTOR SYMPTOMS AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH PARKINSON’S DISEASE M.-Y. Eun1 , M.J. Kim1 , H.M. Lee1 , J.-W. Jang1 , J. Kim1 , C.N. Lee2 , D.-Y. Kwon3 , S.-B. Koh1 . 1 Department of Neurology, Parkinson’s Disease Center, Korea University Guro Hospital, 2 Department of Neurology, Korea University Anam Hospital, 3 Department of Neurology, Korea University Ansan Hospital, Seoul, Republic of Korea Cognitive impairment in Parkinson’s disease (PD) is one of the common nonmotor symptoms (NMS) and is expected to affect health-related quality of life (HrQoL) in patients. However, the association between cognitive impairment in PD and NMS and the clinical significance of cognitive impairment for HrQoL are obscure. In this study, NMS and their impact on HrQoL was evaluated in patients with PD with and without dementia. Sixty-three PD patients were included. The patients’ cognitive status and impact on daily living activities were evaluated by MMSE, Montreal Cognitive Assessment, and Global Deterioration Scale. NMS and HrQoL were assessed with the nonmotor symptoms scales (NMSS) and the 39-item Parkinson’s disease Questionnaires (PDQ-39). The profiles of NMSS in non-demented Parkinson’s disease (PD-ND) patients were compared with that of Parkinson’s disease dementia (PD-D) patients defined by MDS Task Force. The association between NMSS and PDQ-39 were estimated, respectively. NMSS scores were higher in PD-D than PD-ND in all domains except domains of Perceptual problems/Hallucinations and Miscellaneous. In PD-ND, PDQ-39 Summary Index showed a significant correlation with domains of Mood/Apathy (r = 0.622, p < 0.001), Attention/Memory (r = 0.517, p < 0.001), Sleep/Fatigue (r = 0.475, p = 0.001), Gastrointestinal (r = 0.456, p = 0.002), and total NMSS score (r = 0.594, p < 0.001). On the other hand, in PD-D, PDQ39 Summary Index correlated with domains of Cardiovascular (r = 0.586, p = 0.007), Mood/Apathy (r = 0.458, p = 0.042), and total NMSS score (r = 0.573, p = 0.008). In PD-D patients, NMS severity and impact for HrQoL are different from PD-ND patients. Our observation implies the presence of determinants other than known NMS for QOL in PD-D. 1.101 INFLUENCE OF PATIENTS’ EXPECTATIONS ON NON-MOTOR SYMPTOMS AND QUALITY OF LIFE IN PARKINSON’S DISEASE: A MIXED-METHOD STUDY N. Lenihan1 , A. Grinbergs2 , B. Kalanlar3 . 1 National University of Ireland, Galway, Ireland; 2 Brighton & Sussex Medical School, London, UK; 3 Hacettepe University, Ankara, Turkey There is a well-established link between non-motor and motor symptom progression, which significantly impedes Parkinson’s patients’ quality of life. Previous studies have shown that individual differences in optimism have a differential effect on adaptation to PD. It has also been shown that the placebo effect has significant benefits for clinical outcomes. Moreover, studies have convincingly shown the effects of met and unmet expectations on
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clinical outcomes and the wellbeing of patients with conditions such as chronic pain. Therefore, in this project we will test this hypothesis that fulfilled expectations, either positive or negative, have an impact on the clinical outcomes of PD and the quality of life of Parkinson’s patients. This is to understand the effects of patient expectations on non-motor symptoms anxiety and depression in the context of Parkinson’s disease (aPD and dPD, respectively) and consequently on motor symptoms and quality of life. This will be a mixed-methods study measuring patient Parkinson’s symptom severity and self-assessed quality of life using standardized Parkinson’s questionnaires (UPDRS, PDQ-39, NMSS, PEQ) with follow-up interviews to provide rich qualitative data on the patient experience. We expect this study to show that there is a positive correlation between positive expectations and patient quality of life, and a negative correlation between negative expectations and patient quality of life. We also predict that there will be a positive correlation between fulfilled negative expectations and NMS scores, and an inverse correlation between positive fulfilled expectations and NMS scores. 1.102 FACTORS ASSOCIATED WITH FUNCTIONAL PERFORMANCE IN ELDERLY PEOPLE WITH PARKINSON’S DISEASE L.A. Leandro, R.P. Munhoz, H.A.G. Teive. Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paran´ a, Curitiba, Brazil Introduction: Elderly people often have coexisting diseases, mostly chronic-degenerative, including Parkinson’s disease (PD), which if not properly treated tend to have complications and sequelae, which may lead to a decline in functional capacity, compromising the independence and autonomy. Objective: The objective of this study was to determine the level of the functional performance among older adults with PD and correlate it with th scale of Hoehn-Yahr staging (HY) and time of clinical evolution. Patients and Methods: It is a cross-sectional study with an exploratory and descriptive correlational approach where were evaluated 146 elderly patients with PD, divided into three groups: G1 (60–69 years), G2 (70–79 years), and Ge (80–89 years). We used two instruments: demographic data and factors related to health and the Functional Independende Measure (FIM). Results: Elderly people with PD, with longer disease duration, with a value of HY staging higher, had a lower value of FIM scale. Conclusion: The study demonstrated that older people living with PD, with longer disease duartion and higher HY staging, had low scores in the FIM, featuring a worse functional performance. 1.103 THE COMBINATION OF HOMOCYSTEINE AND C-REACTIVE PROTEIN PREDICTS THE OUTCOMES OF CHINESE PATIENTS WITH PARKINSON’S DISEASE AND VASCULAR PARKINSONISM Q. Wang. Neurology Department, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Background: The elevation of plasma homocysteine (Hcy) and C-reactive protein (CRP) has been correlated to an increased risk of Parkinson’s disease (PD) or vascular diseases. Methodology: We performed a cross-sectional study of 88 Chinese patients with PD and VP using a clinical interview and the measurement of plasma Hcy and CRP to determine if Hcy and CRP levels in patients may predict the outcomes. Each patient’s NMS, cognitive deficit, disease severity, and motor status were assessed by the Nonmotor Symptoms Scale (NMSS), MMSE, H&Y, and the unified Parkinson’s disease rating scale part III (UPDRS III), respectively. Findings: We found that 100% of patients with PD and VP presented with NMS. The UPDRS (III) significantly correlated with CRP (P = 0.011) and NMSS (P = 0.042) in PD patients. The H&Y was also correlated with Hcy (P = 0.002), CRP (P = 0.000), and NMSS
141.7±22.9; (2) The incidence of anxiety in PD patients was 39.8%, and the incidences of mild, moderate and severe anxiety were 28.8%, 10.2% and 0.8%, respectively. The scores of PDQ-39 in PD patients with and without anxiety were 120.5±19.1 vs. 138.8±28.8; (3) The incidences of MCI and dementia in PD patients were 69.5% and 6.3%, respectively. The scores of PDQ-39 in PD patients with and without MCI, with and without dementia were 128.0±23.8 vs. 135.1±22.6, 111.0±15.4 vs.132.2±23.4; (4) The scores of HAMA, HAMD, MoCA and MMSE all have linear correlations with the results of PDQ-39 (p < 0.01). Conclusions: Emotional disorders and cognitive impairment are important non-motor symptoms with high incidences and are the pivotal factors compromising the quality of life in PD patients. 1.100 DEMENTIA, NONMOTOR SYMPTOMS AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH PARKINSON’S DISEASE M.-Y. Eun1 , M.J. Kim1 , H.M. Lee1 , J.-W. Jang1 , J. Kim1 , C.N. Lee2 , D.-Y. Kwon3 , S.-B. Koh1 . 1 Department of Neurology, Parkinson’s Disease Center, Korea University Guro Hospital, 2 Department of Neurology, Korea University Anam Hospital, 3 Department of Neurology, Korea University Ansan Hospital, Seoul, Republic of Korea Cognitive impairment in Parkinson’s disease (PD) is one of the common nonmotor symptoms (NMS) and is expected to affect health-related quality of life (HrQoL) in patients. However, the association between cognitive impairment in PD and NMS and the clinical significance of cognitive impairment for HrQoL are obscure. In this study, NMS and their impact on HrQoL was evaluated in patients with PD with and without dementia. Sixty-three PD patients were included. The patients’ cognitive status and impact on daily living activities were evaluated by MMSE, Montreal Cognitive Assessment, and Global Deterioration Scale. NMS and HrQoL were assessed with the nonmotor symptoms scales (NMSS) and the 39-item Parkinson’s disease Questionnaires (PDQ-39). The profiles of NMSS in non-demented Parkinson’s disease (PD-ND) patients were compared with that of Parkinson’s disease dementia (PD-D) patients defined by MDS Task Force. The association between NMSS and PDQ-39 were estimated, respectively. NMSS scores were higher in PD-D than PD-ND in all domains except domains of Perceptual problems/Hallucinations and Miscellaneous. In PD-ND, PDQ-39 Summary Index showed a significant correlation with domains of Mood/Apathy (r = 0.622, p < 0.001), Attention/Memory (r = 0.517, p < 0.001), Sleep/Fatigue (r = 0.475, p = 0.001), Gastrointestinal (r = 0.456, p = 0.002), and total NMSS score (r = 0.594, p < 0.001). On the other hand, in PD-D, PDQ39 Summary Index correlated with domains of Cardiovascular (r = 0.586, p = 0.007), Mood/Apathy (r = 0.458, p = 0.042), and total NMSS score (r = 0.573, p = 0.008). In PD-D patients, NMS severity and impact for HrQoL are different from PD-ND patients. Our observation implies the presence of determinants other than known NMS for QOL in PD-D. 1.101 INFLUENCE OF PATIENTS’ EXPECTATIONS ON NON-MOTOR SYMPTOMS AND QUALITY OF LIFE IN PARKINSON’S DISEASE: A MIXED-METHOD STUDY N. Lenihan1 , A. Grinbergs2 , B. Kalanlar3 . 1 National University of Ireland, Galway, Ireland; 2 Brighton & Sussex Medical School, London, UK; 3 Hacettepe University, Ankara, Turkey There is a well-established link between non-motor and motor symptom progression, which significantly impedes Parkinson’s patients’ quality of life. Previous studies have shown that individual differences in optimism have a differential effect on adaptation to PD. It has also been shown that the placebo effect has significant benefits for clinical outcomes. Moreover, studies have convincingly shown the effects of met and unmet expectations on
S35
clinical outcomes and the wellbeing of patients with conditions such as chronic pain. Therefore, in this project we will test this hypothesis that fulfilled expectations, either positive or negative, have an impact on the clinical outcomes of PD and the quality of life of Parkinson’s patients. This is to understand the effects of patient expectations on non-motor symptoms anxiety and depression in the context of Parkinson’s disease (aPD and dPD, respectively) and consequently on motor symptoms and quality of life. This will be a mixed-methods study measuring patient Parkinson’s symptom severity and self-assessed quality of life using standardized Parkinson’s questionnaires (UPDRS, PDQ-39, NMSS, PEQ) with follow-up interviews to provide rich qualitative data on the patient experience. We expect this study to show that there is a positive correlation between positive expectations and patient quality of life, and a negative correlation between negative expectations and patient quality of life. We also predict that there will be a positive correlation between fulfilled negative expectations and NMS scores, and an inverse correlation between positive fulfilled expectations and NMS scores. 1.102 FACTORS ASSOCIATED WITH FUNCTIONAL PERFORMANCE IN ELDERLY PEOPLE WITH PARKINSON’S DISEASE L.A. Leandro, R.P. Munhoz, H.A.G. Teive. Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal University of Paran´ a, Curitiba, Brazil Introduction: Elderly people often have coexisting diseases, mostly chronic-degenerative, including Parkinson’s disease (PD), which if not properly treated tend to have complications and sequelae, which may lead to a decline in functional capacity, compromising the independence and autonomy. Objective: The objective of this study was to determine the level of the functional performance among older adults with PD and correlate it with th scale of Hoehn-Yahr staging (HY) and time of clinical evolution. Patients and Methods: It is a cross-sectional study with an exploratory and descriptive correlational approach where were evaluated 146 elderly patients with PD, divided into three groups: G1 (60–69 years), G2 (70–79 years), and Ge (80–89 years). We used two instruments: demographic data and factors related to health and the Functional Independende Measure (FIM). Results: Elderly people with PD, with longer disease duration, with a value of HY staging higher, had a lower value of FIM scale. Conclusion: The study demonstrated that older people living with PD, with longer disease duartion and higher HY staging, had low scores in the FIM, featuring a worse functional performance. 1.103 THE COMBINATION OF HOMOCYSTEINE AND C-REACTIVE PROTEIN PREDICTS THE OUTCOMES OF CHINESE PATIENTS WITH PARKINSON’S DISEASE AND VASCULAR PARKINSONISM Q. Wang. Neurology Department, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Background: The elevation of plasma homocysteine (Hcy) and C-reactive protein (CRP) has been correlated to an increased risk of Parkinson’s disease (PD) or vascular diseases. Methodology: We performed a cross-sectional study of 88 Chinese patients with PD and VP using a clinical interview and the measurement of plasma Hcy and CRP to determine if Hcy and CRP levels in patients may predict the outcomes. Each patient’s NMS, cognitive deficit, disease severity, and motor status were assessed by the Nonmotor Symptoms Scale (NMSS), MMSE, H&Y, and the unified Parkinson’s disease rating scale part III (UPDRS III), respectively. Findings: We found that 100% of patients with PD and VP presented with NMS. The UPDRS (III) significantly correlated with CRP (P = 0.011) and NMSS (P = 0.042) in PD patients. The H&Y was also correlated with Hcy (P = 0.002), CRP (P = 0.000), and NMSS