Exploring The Effects Of Anxiety To Health Related Quality Of Life And Its Clinical Related Factors In Patients With Parkinson's Disease

Part1Objective:To evaluate the reliability and validity of the Chinese(Mainland) version of the 8-item Parkinson's disease questionnaire (PDQ8) for patients with Parkinson's disease(PD) in Mainland China.Methods:The study was conducted on 86 PD patients in Mainland China and 86 healthy aged controls. All patients and controls were interviewed to complete PDQ8 and the 39-item Parkinson's disease questionnaire(PDQ39). PD Patients were assessed by the Unified PD Rating Scale (UPDRS) and the modified Hoehn-Yahr (H-Y) stage. The reliability of the questionnaires were examined by the Cronbach's alpha(Cronbach a) and the intraclass correlation coefficient (ICC). The validity was assessed by factor analysis, Spearman correlation analysis, t test, and analysis of variance(ANOVA).Results:There was no evidence of floor or ceiling effects. Both internal consistency reliability(Cronbach ?=0.789) and test-retest reliability(ICC=0.949) were acceptable in the Chinese(Mainland) version of PDQ8. Factor analyses yielded two components on which all 8 questions were substantially loaded (factor loading>0.5 for all) and the cumulative variance contribution rate was 58.6%. In validity analysis, patients had significantly higher PDQ8 scores than healthy aged controls, which demonstrated expected known-group validity. PDQ8 convergent validity with the PDQ39 was significantly high (r=0.827, P<0.001), and criterion validity proved satisfactory. Both PDQ8 and PDQ39 score were strongly correlated with UPDRSII and UPDRSIII scores, and PDQ8 scores could specify the distinct stages of H-Y patients.Conclusions:The Chinese(Mainland) version of the PDQ8 are valid and reliable disease-specific HRQoL instruments for PD patients in Mainland China.Part2Objective:To investigate the health-related quality of life (HRQoL) of Parkinson's disease (PD) and to explore the effects of anxiety to patients' HRQoL.Methods:The sample collected 86 PD patients and 86 healthy aged controls. Basic conditions and PD medicine usages of PD patients were recorded, L-dopa equivalent daily dose (LEDD) was calculated as well. Parkinson's disease questionnaire-8item version (PDQ8) and Beck anxiety inventory (BAI) were used to evaluate the HRQoL and the anxiety of the patients, respectively. Moreover, Unified PD Rating Scale (UPDRS) and Hoehn and Yahr (H-Y) were utilized to assess the motor symptoms of the patients by periods. Additionally, Montreal cognitive assessment (MoCA), Beck depression inventory (BDI), Parkinson's disease sleep scale revised version (PDSS-2), and Epworth sleeping scale (ESS) were chosen to evaluate the patients'cognitive, depression and sleeping disorders, respectively. Furthermore, simple linear regression model was employed to test the relationship between HRQoL and anxiety in PD patients. Besides, single factor analysis was used to determine the attributors of HRQoL. Lastly, multivariate regression analysis was employed to test the influences of anxiety on PD patients.Results:All 8 dimensions of HRQoL of PD patients were damaged. Amongst them, mobility and activities daily living(ADL) were the most serious damaged dimension. PDQ8 and BAI scores were significantly correlated (r=0.581, P<0.05). Multivariate regression analysis demonstrated that PDQ8 scores was positively correlated with BAI, UPDRSII, ESS and BDI scores, with the explained attributiveness of 45.6%, 11.0%,5.0% and 2.0%, respectively.Conclusion:All dimensions of HRQoL are damaged in PD patients. Amongst them, mobility and ADL are the most serious damaged dimension. And PD anxiety is the primary factor which affects patients' HRQoL. Besides, the damage of ADL, hypersomnia and depression will decrease patients' HRQoL as well.Part3Objective:To explore the prevalence and clinical related factors of anxiety in patients with Parkinson's disease (PD).Methods:Using the Beck Anxiety Inventory (BAI) to acess the both 86 PD patients and 86 healthy aged controls. We collected demographic data and anti-Parkinson's medication usage of PD patients, L-dopa equivalent daily dose (LEDD) was calculated as well. According to the scores of BAI, PD patients were divided into the anxiety group and the non-anxiety group. Unified PD Rating Scale (UPDRS) and modified Hoehn and Yahr (H-Y) grade were used to evaluate the severity of the motor symptoms. Montreal cognitive assessment (MoCA), Beck depression inventory (BDI), Parkinson's disease sleep scale (PDSS) and Epworth sleeping scale (ESS) were used to evaluate the non-motor symptoms. And Parkinson's disease questionnaire-8item version (PDQ8) were used to evaluate the health-related quality of life (HRQoL).Result:The prevalence of anxiety in patients with PD is 48.8%, which is significantly higher than that of control group(P<0.05). Demographic data shows that women in the anxiety group was significantly higher than that in the non-anxiety group(P<0.05). In terms of motor symptoms, there were no significant differences between the two groups. Additionally, in terms of anti-Parkinson's medication usage, LEDD of patients were lower than those of patients in the non-anxiety group(P<0.05). In other terms of non-motor symptoms, the anxiety group had higher BDI, PDSS and ESS scores than those of patients in the non-anxiety group(P<0.05). And in terms of HRQoL, anxiety group had higher PDQ8 scores than non-anxiety group(P<0.05). Logistic regression analysis demonstrated that anxiety was correlated with female, depression and LEDD.Conclusion:The prevalence of anxiety is high in PD patients. Female and depression are the risk factors of anxiety in PD while LEDD is the protective factor of anxiety in PD.