Predictors of clinically significant quality of life impairment in Parkinson’s disease
Authors: Santos García Diego , de Deus Fonticoba Teresa , Cores Carlos , Muñoz Guillermo , Paz González Jose M. , Martínez Miró Cristina , Suárez Ester , Jesús Silvia , Aguilar Miquel , Pastor Pau , Planellas Lluis , Cosgaya Marina , García Caldentey Juan , Caballol Nuria , Legarda Inés , Hernández Vara Jorge , Cabo Iria , López Manzanares Luis , González Aramburu Isabel , Ávila Rivera María A. , Catalán Maria J. , Nogueira Víctor , Puente Víctor , Ruíz de Arcos María , Borrué Carmen , Solano Vila Berta , Álvarez Sauco María , Vela Lydia , Escalante Sonia , Cubo Esther , Carrillo Padilla Francisco , Martínez Castrillo Juan C. , Sánchez Alonso Pilar , Alonso Losada Maria G. , López Ariztegui Nuria , Gastón Itziar , Clavero Pedro , Kulisevsky Jaime , Blázquez Estrada Marta , Seijo Manuel , Rúiz Martínez Javier , Valero Caridad , Kurtis Mónica , de Fábregues Oriol , González Ardura Jessica , Ordás Carlos , López Díaz Luis M. , McAfee Darrian , Martinez-Martin Pablo , Mir Pablo ,   COPPADIS Study Group, Adarmes Daniela A. , Almeria Marta , Alonso Cánovas Araceli , Alonso Frech F. , Alonso Redondo Ruben , Álvarez Ignacio , Aneiros Díaz Ángel , Arnáiz Sandra , Arribas Sonia , Ascunce Vidondo Arancha , Bernardo Lambrich Noemí , Bejr-Kasem Helana , Botí María A. , Buongiorno María T. , Cabello González Carolina , Cámara Lorenzo A. , Canfield Medina Héctor , Carrillo Fátima , Casas Elena , Cortina Fernández Ana , Cots Foraster Anna , Crespo Cuevas Ane , Díez-Fairen Mónica , Dotor García-Soto Julio , Erro Elena , Estelrich Peyret Elena , Fernández Guillán Noelia , Gámez Pedro , Gallego Mercedes , García Campos Cristina , García Moreno Jose M. , Gómez Garre María P. , Gómez Mayordomo Vívtor , González Aloy Javier , González García Beatriz , González Palmás María J. , Toledo González , Gabriel R. , Golpe Díaz Ana , Grau Solá Mireia , Guardia Gemma , Horta-Barba Andrea , Idoate Calderón Daniel , Infante Jon , Labandeira Carmen , Labrador Miguel A. , Lacruz Francisco , Lage Castro Melva , Lastres Gómez Sonia , López Seoane Balbino , Lucas del Pozo Sara , Macías Yolanda , Mata Marina , Martí Andres Gloria , Martí María J. , Meitín Maria T. , Menéndez González Manuel , Méndez del Barrio Carlota , Miranda Santiago Javier , Casado Morales , María I. , Moreno Diéguez Antonio , Novo Amado Alba , Novo Ponte Sabela , Pagonabarraga Javier , Pareés Isabel , Pascual-Sedano Berta , Pérez Fuertes Aída , Pérez Noguera Rafael , Planas-Ballvé Ana , Prats Marian A. , Prieto Jurczynska Cristina , Pueyo Morlans Mercedes , Puig Daví Arnayu , Redondo Rafales Nuria , Rodríguez Méndez Luisa , Rodríguez Pérez Amparo B. , Roldán Florinda , Sánchez-Carpintero Macarena , Sánchez Díez Gemma , Sánchez Rodríguez Antonio , Santacruz Pilar , Segundo Rodríguez José C. , Sierra Peña María , Tartari Juan P. , Vargas Laura , Villanueva Clara , Vives Bárbara , Villar María D. 
Published: December 2021

Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.