Quality of life in Parkinson's disease: A systematic review and meta-analysis of comparative studies

Na Zhao, Yuan Yang, Ling Zhang, Qinge Zhang, Lloyd Balbuena, Gabor S Ungvari, Yu-Feng Zang, Yu-Tao Xiang, Na Zhao, Yuan Yang, Ling Zhang, Qinge Zhang, Lloyd Balbuena, Gabor S Ungvari, Yu-Feng Zang, Yu-Tao Xiang

Abstract

Background: Studies regarding the impact of Parkinson's disease (PD) on quality of life (QOL) have reported conflicting results, and the underlying QOL domains require further study. In order to understand the association between PD and QOL, we conducted this meta-analysis to systematically compare QOL between PD patients and healthy controls.

Method: The PubMed, PsycINFO, EMBASE, and Web of Science databases were systematically searched. Data were analyzed using the random-effects model.

Results: Twenty studies covering 2707 PD patients and 150,661 healthy controls were included in the study. Compared with healthy controls, PD patients had significantly poorer QOL overall and in most domains with moderate to large effects sizes. Different QOL measures varied in their association with quality of life, with the Parkinson's Disease Questionnaire-39 (PDQ-39) having the largest effect size (standard mean difference, SMD = -1.384, 95% CI: -1.607, -1.162, Z = 12.189, P < 0.001), followed by the Europe Quality of Life Questionnaire-visual analogue scale (EQ-VAS) (SMD = -1.081, 95% CI: -1.578, -0.584, Z = -4.265, P < 0.001), Europe Quality of Life Questionnaire-5D (EQ-5D) (SMD = -0.889, 95% CI: -1.181, -0.596, Z = -5.962, P < 0.001), and the Short-form Health Survey (SF) scales (physical dimension: SMD = -0.826, 95% CI: -1.529, -0.123, Z = -2.303, P = 0.021; mental dimension: SMD = -0.376, 95% CI: -0.732, -0.019, Z = -2.064, P = 0.039).

Conclusion: PD patients had lower QOL compared with healthy controls in most domains, especially in physical function and mental health. Considering the negative impact of poor QOL on daily life and functional outcomes, effective measures should be developed to improve QOL in this population.

Keywords: Parkinson's disease; comparative study; meta-analysis; quality of life.

Conflict of interest statement

The authors have no conflicts of interest to declare.

© 2020 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
PRISMA flowchart
Figure 2
Figure 2
QOL comparison between PD patients and control group (CG) using WHOQOL
Figure 3
Figure 3
QOL comparisons between PD patients and control group (CG) using SF scales

References

    1. Muangpaisan W, Mathews A, Hori H, Seidel D. A systematic review of the worldwide prevalence and incidence of Parkinson's disease. J Med Assoc Thai. 2011;94(6):749.
    1. Tysnes OB, Storstein A. Epidemiology of Parkinson's disease. J Neural Transm (Vienna). 2017;124(8):901–905.
    1. Wirdefeldt K, Adami H‐O, Cole P, Trichopoulos D, Mandel J. Epidemiology and etiology of Parkinson's disease: a review of the evidence. Eur J Epidemiol. 2011;26(1):1.
    1. Garcia‐Ruiz PJ, Chaudhuri KR, Martinez‐Martin P. Non‐motor symptoms of Parkinson's disease A review… from the past. J Neurol Sci. 2014;338(1‐2):30–33.
    1. WHO . The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403–1409.
    1. Den Oudsten BL, Van Heck GL, De Vries J. Quality of life and related concepts in Parkinson's disease: a systematic review. Movem Disord. 2007;22(11):1528–1537.
    1. Park S, Kim R, Shin JH, Kim HJ, Paek SH, Jeon B. The probable REM sleep behavior disorder negatively affects health‐related quality of life in Parkinson's disease with bilateral subthalamic nucleus stimulation. Parkinsonism Relat Disord. 2020;81:136–139.
    1. Paolucci T, Iosa M, Morone G, et al. Romberg ratio coefficient in quiet stance and postural control in Parkinson's disease. Neurol Sci. 2018;39(8):1355–1360.
    1. Vossius C, Nilsen OB, Larsen JP. Health state values during the first year of drug treatment in early‐stage Parkinson's disease: a prospective, population‐based, cohort study. Drugs Aging. 2009;26(11):973–980.
    1. Hariz GM, Forsgren L. Activities of daily living and quality of life in persons with newly diagnosed Parkinson's disease according to subtype of disease, and in comparison to healthy controls. Acta Neurol Scand. 2011;123(1):20–27.
    1. Hendred SK, Foster ER. Use of the World Health Organization quality of life assessment short version in mild to moderate Parkinson disease. Arch Phys Med Rehabil. 2016;97(12):2123–2129.e2121.
    1. Prasuhn J, Piskol L, Vollstedt EJ, et al. Non‐motor symptoms and quality of life in subjects with mild parkinsonian signs. Acta Neurol Scand. 2017;136(5):495–500.
    1. Park HJ, Sohng KY, Kim S. Validation of the Korean version of the 39‐Item Parkinson's Disease Questionnaire (PDQ‐39). Asian Nurs Res. 2014;8(1):67–74.
    1. Soh S‐E, Morris ME, McGinley JL. Determinants of health‐related quality of life in Parkinson's disease: a systematic review. Parkinsonism Relat Disord. 2011;17(1):1–9.
    1. van Uem JM, Marinus J, Canning C, et al. Health‐Related Quality of Life in patients with Parkinson's disease–a systematic review based on the ICF model. Neurosci Biobehav Rev. 2016;61:26–34.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–269.
    1. Hughes AJ, Daniel SE, Blankson S, Lees AJ. A clinicopathologic study of 100 cases of Parkinson's disease. Arch Neurol. 1993;50(2):140–148.
    1. Rizzo G, Copetti M, Arcuti S, Martino D, Fontana A, Logroscino G. Accuracy of clinical diagnosis of Parkinson disease: a systematic review and meta‐analysis. Neurology. 2016;86(6):566–576.
    1. Postuma RB, Berg D, Stern M, et al. MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord. 2015;30(12):1591–1601.
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ. 2003;327(7414):557–560.
    1. Peterson J, Welch V, Losos M, Tugwell P. The Newcastle‐Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta‐analyses. Ottawa: Ottawa Hospital Research Institute; 2011.
    1. Wells G, Shea B, O'Connell D, et al. The Newcastle‐Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta‐analyses. Ottawa: Ottawa Hospital Research Institute; 2014.
    1. Leucht S, Komossa K, Rummel‐Kluge C, et al. A meta‐analysis of head‐to‐head comparisons of second‐generation antipsychotics in the treatment of schizophrenia. Am J Psychiatry. 2009;166(2):152–163.
    1. Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Vol. 4 Cochrane: John Wiley and Sons; 2011. Available from
    1. DerSimonian R, Laird N. Meta‐Analysis in Clinical Trials; 1986.
    1. Egger M, Smith GD, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–634.
    1. Adewusi JK, Hadjivassiliou M, Vinagre‐Aragón A, et al. Sensory neuropathic symptoms in idiopathic Parkinson's disease: prevalence and impact on quality of life. Acta Neurol Belg. 2018;118(3):445–450.
    1. Arun MP, Bharath S, Pal PK, Singh G. Relationship of depression, disability, and quality of life in Parkinson's disease: a hospital‐based case‐control study. Neurol India. 2011;59(2):185–189.
    1. Chotinaiwattarakul W, Dayalu P, Chervin RD, Albin RL. Risk of sleep‐disordered breathing in Parkinson's disease. Sleep Breathing = Schlaf & Atmung. 2011;15(3):471–478.
    1. Chu SY, Tan CL. Subjective self‐rated speech intelligibility and quality of life in patients with Parkinson's disease in a Malaysian sample. Open Publ Health J. 2018;11(1):485–493.
    1. Fan XJ, Wang DL, Hellman B, et al. Assessment of health‐related quality of life between people with Parkinson's disease and non‐Parkinson's: using data drawn from the ‘100 for Parkinson's’ smartphone‐based prospective study. Int J Environ Res Publ Health. 2018;15(11):2358–2358.
    1. Greene T, Camicioli R. Depressive symptoms and cognitive status affect health‐related quality of life in older patients with Parkinson's disease. J Am Geriatr Soc. 2007;55(11):1888–1890.
    1. Hobson P, Meara J. Mortality and quality of death certification in a cohort of patients with Parkinson's disease and matched controls in North Wales, UK at 18 years: a community‐based cohort study. BMJ Open. 2018;8(2):e018969.
    1. Jakobsson U, Westergren A, Lindskov S, Hagell P. Construct validity of the SF‐12 in three different samples. J Eval Clin Pract. 2012;18(3):560–566.
    1. Kang P, Kloke J, Jain S. Olfactory dysfunction and parasympathetic dysautonomia in Parkinson's disease. Clin Autonomic Res. 2012;22(4):161–166.
    1. Prell T, Teschner U, Witte OW, Kunze A. Current and desired quality of life in people with Parkinson's disease: the Calman gap increases with depression. J Clin Med. 2020;9(5):1496.
    1. Pusswald G, Wiesbauer P, Pirker W, Novak K, Foki T, Lehrner J. Depression, quality of life, activities of daily living, and subjective memory after deep brain stimulation in Parkinson disease‐A reliable change index analysis. Int J Geriatr Psychiatry. 2019;34(11):1698–1705.
    1. Swinn L, Schrag A, Viswanathan R, Bloem BR, Lees A, Quinn N. Sweating dysfunction in Parkinson's disease. Mov Disord. 2003;18(12):1459–1463.
    1. Valeikiene V, Ceremnych J, Alekna V, Juozulynas A. Differences in WHOQOL‐100 domain scores in Parkinson's disease and osteoarthritis. Med Sci Monitor: Int Med J Exp Clin Res. 2008;14(4):Cr221‐Cr227.
    1. Winter Y, von Campenhausen S, Popov G, et al. Social and clinical determinants of quality of life in Parkinson's disease in a Russian cohort study. Parkinsonism Relat Disord. 2010;16(4):243–248.
    1. Yoon JE, Kim JS, Jang W, et al. Gender differences of nonmotor symptoms affecting quality of life in Parkinson disease. Neurodegener Dis. 2017;17(6):276–280.
    1. Kasten M, Kertelge L, Tadic V, et al. Depression and quality of life in monogenic compared to idiopathic, early‐onset Parkinson's disease. Mov Disord. 2012;27(6):754–759.
    1. Vescovelli F, Sarti D, Ruini C. Well‐being and distress of patients with Parkinson's disease: a comparative investigation. Int Psychogeriatr. 2019;31(1):21–30.
    1. Jenkinson C, Peto V, Fitzpatrick R, Greenhall R, Hyman N. Self‐reported functioning and well‐being in patients with Parkinson's disease: comparison of the short‐form health survey (SF‐36) and the Parkinson's Disease Questionnaire (PDQ‐39). Age Ageing. 1995;24(6):505–509.
    1. Quittenbaum BH, Grahn B. Quality of life and pain in Parkinson's disease: a controlled cross‐sectional study. Parkinsonism Relat Disord. 2004;10(3):129–136.
    1. Riazi A, Hobart JC, Lamping DL, et al. Using the SF‐36 measure to compare the health impact of multiple sclerosis and Parkinson's disease with normal population health profiles. J Neurol Neurosurg Psychiatry. 2003;74(6):710–714.
    1. Yamabe K, Liebert R, Flores N, Pashos C. Health‐related quality‐of‐life, work productivity, and economic burden among patients with Parkinson's disease in Japan. J Med Econ. 2018;21(12):1206–1212.
    1. Baig F, Lawton M, Rolinski M, et al. Delineating nonmotor symptoms in early Parkinson's disease and first‐degree relatives. Mov Disord. 2015;30(13):1759–1766.
    1. Barber TR, Lawton M, Rolinski M, et al. Prodromal parkinsonism and neurodegenerative risk stratification in REM sleep behavior disorder. Sleep. 2017;40(8):zsx071.
    1. Reuther M, Spottke EA, Klotsche J, et al. Assessing health‐related quality of life in patients with Parkinson's disease in a prospective longitudinal study. Parkinsonism Relat Disord. 2007;13(2):108–114.
    1. Schrag A, Jahanshahi M, Quinn N. How does Parkinson's disease affect quality of life? A comparison with quality of life in the general population. Mov Disord. 2000;15(6):1112–1118.
    1. Tamás G, Gulácsi L, Bereczki D, et al. Quality of life and costs in Parkinson's disease: a cross sectional study in Hungary. PLoS One. 2014;9(9):e107704.
    1. Vela L, Martínez Castrillo JC, García Ruiz P, et al. The high prevalence of impulse control behaviors in patients with early‐onset Parkinson's disease: a cross‐sectional multicenter study. J Neurol Sci. 2016;368:150–154.
    1. Winter Y, von Campenhausen S, Arend M, et al. Health‐related quality of life and its determinants in Parkinson's disease: results of an Italian cohort study. Parkinsonism Relat Disord. 2011;17:265‐269.
    1. Dogan VB, Koksal A, Dirican A, Baybas S, Dirican A, Dogan GB. Independent effect of fatigue on health‐related quality of life in patients with idiopathic Parkinson's disease. Neurol Sci. 2015;36(12):2221–2226.
    1. Haapaniemi TH, Sotaniemi KA, Sintonen H, Taimela E. The generic 15D instrument is valid and feasible for measuring health related quality of life in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2004;75(7):976–983.
    1. Pohar SL, Jones CA. The burden of Parkinson disease (PD) and concomitant comorbidities. Arch Gerontol Geriatr. 2009;49(2):317–321.
    1. Karlsen KH, Larsen JP, Tandberg E, Maeland JG. Influence of clinical and demographic variables on quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 1999;66(4):431–435.
    1. Larsen JP, Karlsen K, Tandberg E. Clinical problems in non‐fluctuating patients with Parkinson's disease: a community‐based study. Mov Disord. 2000;15(5):826–829.
    1. Gustafsson H, Nordström P, Stråhle S, Nordström A. Parkinson's disease: a population‐based investigation of life satisfaction and employment. J Rehabil Med. 2015;47(1):45–51.
    1. Benli E, Ozer FF, Kaya Y, Ozcan TS, Ayyildiz A. Is there a difference between Parkinson disease patients and a control group in terms of urinary symptoms and quality of life? Turk J Med Sci. 2016;46(6):1665–1671.
    1. Ritsner M, Modai I, Endicott J, et al. Differences in quality of life domains and psychopathologic and psychosocial factors in psychiatric patients. J Clin Psychiatry. 2000;61(11):880–889; quiz 890.
    1. Cubo E, Rojo A, Ramos S, et al. The importance of educational and psychological factors in Parkinson's disease quality of life. Eur J Neurol. 2002;9(6):589–593.
    1. Li W, Reavley NJAPP. Patients' and caregivers' knowledge and beliefs about mental illness in mainland China. A systematic review. Asia‐Pacific Psychiatry. 2020:e12423.
    1. Huang Z, Jiang C, Li L, et al. Correlations between dopaminergic dysfunction and abnormal metabolic network activity in REM sleep behavior disorder. J Cereb Blood Flow and Metab. 2020;40(3):552–562.
    1. Wu P, Yu H, Peng S, et al. Consistent abnormalities in metabolic network activity in idiopathic rapid eye movement sleep behaviour disorder. Brain: J Neurol. 2014;137(Pt 12):3122–3128.
    1. Holtbernd F, Gagnon JF, Postuma RB, et al. Abnormal metabolic network activity in REM sleep behavior disorder. Neurology. 2014;82(7):620–627.
    1. Balzer‐Geldsetzer M, Klotsche J, Consortium L, Dodel R, Riedel O. Quality of life in a German cohort of Parkinson's patients assessed with three different measures. J Neurol. 2018;265(11):2713–2722.
    1. Martinez‐Martin P, Jeukens‐Visser M, Lyons KE, et al. Health‐related quality‐of‐life scales in Parkinson's disease: critique and recommendations. Mov Disord. 2011;26(13):2371–2380.
    1. Karlsen KH, Tandberg E, Årsland D, Larsen JP. Health related quality of life in Parkinson's disease: a prospective longitudinal study. J Neurol Neurosurg Psychiatry. 2000;69(5):584–589.
    1. Connolly BS, Lang AE. Pharmacological treatment of Parkinson disease: a review. JAMA. 2014;311(16):1670–1683.
    1. Dafsari HS, Dos Santos Ghilardi MG, Visser‐Vandewalle V, et al. Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease. Brain Stimul. 2020;13(6):1697–1705.
    1. You Z, Wu YY, Wu R, Xu ZX, Wu X, Wang XP. Efforts of subthalamic nucleus deep brain stimulation on cognitive spectrum: from explicit to implicit changes in the patients with Parkinson's disease for 1 year. CNS Neurosci Ther. 2020;26(9):972–980.
    1. Cernera S, Eisinger RS, Wong JK, et al. Long‐term Parkinson's disease quality of life after staged DBS: STN vs GPi and first vs second lead. NPJ Parkinson's Dis. 2020;6:13.
    1. Rughani A, Schwalb JM, Sidiropoulos C, et al. Congress of neurological surgeons systematic review and evidence‐based guideline on subthalamic nucleus and globus pallidus internus deep brain stimulation for the treatment of patients with Parkinson's disease: executive summary. Neurosurgery. 2018;82(6):753–756.
    1. Zhou C, Guan XJ, Guo T, et al. Progressive brain atrophy in Parkinson's disease patients who convert to mild cognitive impairment. CNS Neurosci Ther. 2020;26(1):117–125.
    1. Shen YT, Wang JW, Wang M, et al. BST1 rs4698412 allelic variant increases the risk of gait or balance deficits in patients with Parkinson's disease. CNS Neurosci Ther. 2019;25(4):422–429.
    1. Damiano AM, Snyder C, Strausser B, Willian MK. A review of health‐related quality‐of‐life concepts and measures for Parkinson's disease. Qual Life Res. 1999;8(3):235–243.
    1. Marinus J, Ramaker C, van Hilten JJ, Stiggelbout AM. Health related quality of life in Parkinson's disease: a systematic review of disease specific instruments. J Neurol Neurosurg Psychiatry. 2002;72(2):241–248.
    1. Fonseca LC, Tedrus GM, Rezende AL, Giordano HF. Coherence of brain electrical activity: a quality of life indicator in Alzheimer's disease? Arq Neuropsiquiatr. 2015;73(5):396–401.
    1. Santos Garcia D, Jesus S, Aguilar M, et al. COPPADIS‐2015 (COhort of Patients with PArkinson's DIsease in Spain, 2015): an ongoing global Parkinson's disease project about disease progression with more than 1000 subjects included. Results from the baseline evaluation. Eur J Neurol. 2019;1399–1407.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi