Skip to main content
Log in

Quality of life in a German cohort of Parkinson’s patients assessed with three different measures

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Background

Parkinson’s disease (PD) is characterized by severe motor and non-motor symptoms reducing patients’ quality of life (QoL). Instruments have been well established for QoL assessments in PD, including the EuroQol (EQ-5D), the Parkinson’s disease questionnaire (PDQ-39), or rather uncommon, like the WHOQOL-100. So far, the impact of variables has been investigated for each of these measures separately in different study populations, limiting the comparability of the results. Thus, this study compared the EQ-5D, PDQ-39, and the WHOQOL-100 (with its short-form WHOQOL-BREF) in the same study population.

Methods

Seventy-five PD outpatients were assessed in a prospective study, including disease severity according to Hoehn and Yahr stage (HY) and Unified Parkinson Disease Rating Scale (UPDRS). The Geriatric Depression Scale (GDS-15) screened for depression.

Results

Decreased QoL was found with all three instruments. In multivariate models, sex and treatment complications had an impact on QoL according to all three measures, while duration of PD and HY was not associated with QoL in any of them. Depression was relevant for the WHOQOL-100/WHOQOL-BREF and the PDQ-39, but not for the EQ-5D. The total variances explained by the WHOQOL-100, WHOQOL-BREF, PDQ-39, and the EQ-5D were 0.27, 0.34, 0.70, and 0.50, respectively.

Conclusions

The associations between clinical aspects of PD and QoL vary substantially among all three measures. Importantly, depression as a frequent comorbidity in PD is underestimated by the EQ-5D, but not by the PDQ-39 and the WHOQOL-100/WHOQOL-BREF. In turn, motor impairments are underestimated by the latter and associated strongest with QoL in the EQ-5D.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. De Rijk M, Tzourio C, Breteler M et al (1997) Prevalence of parkinsonism and Parkinson’s disease in Europe: the EUROPARKINSON collaborative study. J Neurol Neurosurg Psychiatr 62:10–15

    Article  Google Scholar 

  2. Bach J-P, Riedel O, Klotsche J, Spottke A, Dodel R, Wittchen H-U (2012) Impact of complications and comorbidities on treatment costs and health-related quality of life in patients with Parkinson’s disease. J Neurol Sci 314:41–47

    Article  PubMed  Google Scholar 

  3. Reuter I, Ebersbach G (2012) Efficacy of exercise in Parkinson’s Disease. Akt Neurol 39:236–247

    Article  Google Scholar 

  4. The WHOQOL Group (1998) The World Health Organization quality of life assessment (WHOQOL): development and general psychometric properties. Soc Sci Med 46:1569–1585

    Article  Google Scholar 

  5. Martinez-Martin P, Jeukens-Visser M, Lyons KE et al (2011) Health-related quality-of-life scales in Parkinson’s disease: critique and recommendations. Mov Disord 26:2371–2380

    Article  PubMed  Google Scholar 

  6. Chen FP, Chang CM, Shiu JH et al (2015) A clinical study of integrating acupuncture and western medicine in treating patients with Parkinson’s Disease. Am J Chin Med 43:407–423

    Article  PubMed  Google Scholar 

  7. Hendred SK, Foster ER (2016) Use of the World Health Organization quality of life assessment short version in mild to moderate Parkinson Disease. Arch Phys Med Rehab 97:2123–2129

    Article  Google Scholar 

  8. Hirayamau MS, Gobbi S, Gobbi LTB, Stella F (2008) Quality of life (QoL) in relation to disease severity in Brazilian Parkinson’s patients as measured using the WHOQOL-BREF. Arch Gerontol Geriatr 46:147–160

    Article  Google Scholar 

  9. Schestatsky P, Zanatto VC, Margis R et al (2006) Quality of life in a Brazilian sample of patients with Parkinson’s disease and their caregivers. Rev Bras Psiquiatr 28:209–211

    Article  PubMed  Google Scholar 

  10. Valeikiene V, Ceremnych J, Alekna V, Jumulynasam A (2008) Differences in WHOQOL-100 domain scores in Parkinson’s disease and osteoarthritis. Med Sci Mon 14:CR221–CR227

    Google Scholar 

  11. Hughes A, Daniel S, Kilford L, Lees A (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinicopathological study of 100 cases. J Neurol Neurosurg Psychiatr 55:181–184

    Article  CAS  Google Scholar 

  12. Balzer-Geldsetzer M, Braga da Costa AS, Kronenbürger M (2011) Parkinson’s disease and dementia: a longitudinal study (DEMPARK). Neuroepidemiol 37:168–176

    Article  Google Scholar 

  13. Hoehn M, Yahr M (1967) Parkinsonism: onset, progression and mortality. Neurol 17:427–442

    Article  CAS  Google Scholar 

  14. Fahn S (1987) Unified Parkinson’s disease rating scale. In: Fahn S, Calne D (eds) Recent developments in Parkinson’s Disease. MacMillan Healthcare Information, Florham Park, pp 153–163

    Google Scholar 

  15. Folstein M, Folstein S, McHugh P (1975) Mini-Mental state: a practical method for grading the mental state of patients by the clinician. J Psychiatr Res 12:189–198

    Article  CAS  PubMed  Google Scholar 

  16. Kalbe E, Calabrese P, Kohn N et al (2008) Screening for cognitive deficits in Parkinson’s disease with the Parkinson neuropsychometric dementia assessment (PANDA) instrument. Parkinsonism Relat Disord 14:93–101

    Article  PubMed  Google Scholar 

  17. Petersen RC (2004) Mild cognitive impairment as a diagnostic entity. J Int Med 256:183–194

    Article  CAS  Google Scholar 

  18. Emre M, Aarsland D, Brown R et al (2007) Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 22:1689–1707

    Article  PubMed  Google Scholar 

  19. Yesavage J, Brink T, Rose T et al (1983) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17:37–49

    Article  CAS  Google Scholar 

  20. Schrag A, Barone P, Brown R et al (2007) Depression rating scales in Parkinson’s disease: critique and recommendations. Movement Disord 22:1077–1092

    Article  PubMed  Google Scholar 

  21. Brooks R (1996) Euroqol—the current state of play. Health Pol (Amst) 37:53–72

    Article  CAS  Google Scholar 

  22. Jenkinson C, Fitzpatrick R, Peto V, Greenhall R, Hyman N (1997) The Parkinson’s disease questionnaire (PDQ-39): development and validation of a Parkinson’s disease summary index score. Age Ageing 26:353–357

    Article  CAS  PubMed  Google Scholar 

  23. Greiner W, Claes C, Busschbach J, von der Schulenburg J (2005) Validating the EQ-5D with time trade off for the German population. Eur J Health Econ 6:123–130

    Google Scholar 

  24. Peto V, Jenkinson C, Fitzpatrick R, Greenhall R (1995) The development and validation of a short measure of functioning and well-being for individuals with Parkinson’s disease. Qual Life Res 4:241–248

    Article  CAS  PubMed  Google Scholar 

  25. Angermeyer MC, Kilian R, Matschinger (2000) WHOQOL-100 und WHQOL-BREF. Hogrefe, Göttingen

    Google Scholar 

  26. Masthoff ED, Trompenaars FJ, Van Heck GL, Hodiamont PP, De Vries J (2005) Validation of the WHO quality of life assessment instrument (WHOQOL-100) in a population of Dutch adult psychiatric outpatients. Eur Psychiatr 20:465–473

    Article  Google Scholar 

  27. Klotsche J, Minden K, Thon A, Ganser G, Urban A, Horneff G (2014) Improvement in health-related quality of life for children with juvenile idiopathic arthritis after start of treatment with etanercept. Arthr Care Res 66:253–262

    Article  CAS  Google Scholar 

  28. Alonso J, Ferrer M, Gandek B et al (2004) Health-related quality of life associated with chronic conditions in eight countries: results from the International Quality of Life Assessment (IQOLA) Project. Qual Life Res 13:283–298

    Article  PubMed  Google Scholar 

  29. da Rocha NS, Fleck MP (2019) Evaluation of quality of life in adults with chronic health conditions: the role of depressive symptoms. Rev Brasil Psiquiatr 32:119–124

    Article  Google Scholar 

  30. van Uem JMT, Marinus J, Canning C et al (2016) Health-related quality of life in patients with Parkinson’s disease a systematic review based on the ICF model. Neurosci Biobehav Rev 61:26–34

    Article  PubMed  Google Scholar 

  31. Lucas-Carrasco R, Pascual-Sedano B, Galan I, Kulisevsky J, Sastre-Garriga J, Gomez-Benito J (2011) Using the WHOQOL-DIS to measure quality of life in persons with physical disabilities caused by neurodegenerative disorders. Neurodegen Dis 8:178–186

    Article  Google Scholar 

  32. König H, Bernert S, Angermeyer M (2005) Health status of the German population: results of a representative survey using the EuroQol questionnaire. Gesundheitswesen 67:173–182

    Article  PubMed  Google Scholar 

  33. Schrag A, Jahanshahi M, Quinn N (2000) How does Parkinson’s disease affect quality of life? A comparison with quality of life in the general population. Mov Disord 15:1112–1118

    Article  CAS  PubMed  Google Scholar 

  34. Abboud H, Genc G, Thompson NR et al (2017) Predictors of functional and quality of life outcomes following deep brain stimulation surgery in Parkinson’s disease patients: DISEASE, patient, and surgical Factors. Parkinsons Dis 2017:5609163. https://doi.org/10.1155/2017/5609163

    Article  PubMed  PubMed Central  Google Scholar 

  35. Bettecken K, Bernhard F, Sartor J et al (2017) No relevant association of kinematic gait parameters with health-related quality of life in Parkinson’s disease. Plos One 12:e0176816

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Lindgren HIV, Qvarfordt P, Bergman S, Gottsater A, Swedish Endovasc Claudication S (2018) Primary stenting of the superficial femoral Artery in patients with intermittent claudication has durable effects on health-related quality of life at 24 months: results of a randomized controlled trial. Cardiovasc Intervent Radiol 41:872–881

    Article  PubMed  PubMed Central  Google Scholar 

  37. Den Oudsten BL, Van Heck GL, De Vries J (2007) The suitability of patient-based measures in the field of Parkinson’s disease: a systematic review. Mov Disord 22:1390–1401

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Data were generated within the LANDSCAPE study (Representatives of the participating centers are: K. Reetz, Department of Neurology, RWTH Aachen University, Aachen; JARA—Translational Brain Medicine, Jülich and Aachen; A. Spottke, Department of Neurology, University of Bonn, and German Center for Neurodegenerative Diseases, Bonn; Department of Psychiatry, University of Bonn, Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn; (A) Storch, Department of Neurology, University Medical Center Rostock; S. Baudrexel, Department of Neurology, Goethe University, Frankfurt/Main; (B) Mollenhauer, Paracelsus-Elena-Klinik, Kassel; Institute of Neuropathology, University Medical Center Goettingen, Goettingen; D. Berg, Department of Neurology, UKSH Campus Kiel, Kiel; I. Liepelt, Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tuebingen, and German Center for Neurodegenerative Diseases, Tuebingen; J. Kassubek, Department of Neurology, University of Ulm; E. Kalbe, Department of Medical Psychology, University Clinic Cologne; H.U. Wittchen, Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden). The LANDSCAPE study is part of the Competence Network Degenerative Dementias (KNDD) which was funded by the German Federal Ministry of Education and Research (project number 01GI1008C).

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to O. Riedel.

Ethics declarations

Conflicts of interest

All authors declare that they have no conflicts of interests.

Ethical standards

The DEMPARK/LANDSCAPE study was approved by the Ethics Committee of Philipps University of Marburg (approval numbers 178/07 and 25/11) and, subsequently, by the local ethics committees of the participating centers. Written informed consent was obtained from all the participants before study entry.

Additional information

The members of LANDSCAPE Consortium are listed in the Acknowledgements section.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 24 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Balzer-Geldsetzer, M., Klotsche, J., LANDSCAPE Consortium. et al. Quality of life in a German cohort of Parkinson’s patients assessed with three different measures. J Neurol 265, 2713–2722 (2018). https://doi.org/10.1007/s00415-018-9047-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-018-9047-9

Keywords

Navigation