Clinical Feature And Correlation Factors Of Non-motor Symptoms And The Factors Influencing HRQoL In Parkinson's Disease

BackgroundParkinson's Disease (PD) is a common degenerative disease in nervous system of the elders. With the aging of the population and the aggravated environmental pollution, the tendency of the prevalence of PD is rising. Although PD will not shorten the lifetime of the patients obviously, the quality of life is dicreased by the restriction of locomotor activity of the patients. People begin to know the non-motor symptoms(NMS) induce the decreasing of the quality of life gravely besides the movement disorder for the past few years.ObjectiveOur study investigate the clinical features and correlation factors of NMS in PD. We also try to find the factors of NMS which may have the influence on health related quality of life (HRQoL) of the patients with PD.Methods1. 87 definitely diagnoused PD patients in Neurology Department of our hospital were selected from Feb 2005 to Apr 2008. The diagnostic criteria of PD refer to the UK PD Brain Bank criteria.2. All of the PD patients were interviewed in clinic by a neurologist regarding name, gender, age of onset, occupation, pathogenesis and clinic symptoms. After neurogenic examination, the neurologist evaluates the Hoehn-Yahr scale.3. All the patients completed the following questionnaire of Non-motor symtoms in PD, and the Unified Parkinson's Disease Rating Scale. We use the second part of UPDRS to evaluate the HRQoL of PD4. Statistic Manual: The data were analyzed using SPSS 11.0 for Windows. This study applied as follows statistical methods percent distribution, Chi-square tese and Fisher's exact test. A level of significance is p<0.05. Use multiple regression analysis determine the most influence factors for HRQoL of PD.Results: 1. Among the 87 patients, 48 male and 39 female, mean age is 56.95±2.37 years old, mean course of disease is 4.35±1.12 years, man H-Y grade is 2.24±0.25, mean UPDRSⅡgrade is 10.37±1.58.2.53 PD patients appear at least one item of NMS (60.92%) in all of 87 PD patients. There are 11 patients appear cognitive impairment (12.64%),21 patients appear mental disorders(24.13%), 24 patients appear sleep disorders(27.58%), 42 patients appear autonomic nerves disorders(48.27%), 19 patients appear sensation disorders(21.83%).3. NMS has significant correlations with H-Y grade and clinical pattern, which has no significant correlation with age of onset, pathogenesis and sex .4. Through multiple linear regression, we find H-Y grade, sleep disorders, autonomic nerves disorders and cognitive impairment have affect on the HRQoL (grade of UPDRSⅡ).Conclusion1. Although the majority of problem for PD patients are thought to be motor (tremor, slowness, gait difficulties, imbalance and so on), the NMS in PD can be quit significant. These symptoms include cognitive impairment: recent memory decent , dementia; mental disorders: emotional depression, anxiety, hallucinations; autonomic nerves disorders: constipation, salivation, deglutition disorders, urination disorders, hyperhidrosis; sleep disorders; limbs numbness, pain, and hyposmia.2. The increasing of movement disorders and the rigidity type of PD can complicate with NMS. The onset of age, course of disease and sex have no obvious association with the NMS.3. H-Y grade, sleep disorders, autonomic nerves disorders and cognitive impairment will affect the HRQoL of PD patients.