Handicap as a Measure of Perceived-Health Status in Parkinson's Disease.

Autor: Silva DP; Department of Neurosciences and Mental Health Hospital de Santa Maria, CHULN Lisbon Portugal., Coelho M; Department of Neurosciences and Mental Health Hospital de Santa Maria, CHULN Lisbon Portugal.; Instituto de Medicina Molecular Lisbon Portugal., Soares T; Instituto de Medicina Molecular Lisbon Portugal., Vale TC; Federal University of Juiz de Fora Minas Gerais Brazil., Correia Guedes L; Department of Neurosciences and Mental Health Hospital de Santa Maria, CHULN Lisbon Portugal.; Instituto de Medicina Molecular Lisbon Portugal., Maciel ROH; Movement Disorders Unit Federal University of Minas Gerais Belo Horizonte Brazil., Antunes AP; Department of Neurosciences and Mental Health Hospital de Santa Maria, CHULN Lisbon Portugal., Camargos ST; Movement Disorders Unit Federal University of Minas Gerais Belo Horizonte Brazil., Valadas A; Department of Neurosciences and Mental Health Hospital de Santa Maria, CHULN Lisbon Portugal.; Instituto de Medicina Molecular Lisbon Portugal., Godinho C; Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM)., Maia DP; Movement Disorders Unit Federal University of Minas Gerais Belo Horizonte Brazil., Pita Lobo P; Department of Neurosciences and Mental Health Hospital de Santa Maria, CHULN Lisbon Portugal.; Instituto de Medicina Molecular Lisbon Portugal., Maia RD; Movement Disorders Unit, Hospital Universitário Cassiano Antônio Moraes Federal University of Espírito Santo Espírito Santo Brazil., Teodoro T; Instituto de Medicina Molecular Lisbon Portugal.; Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals National Health Service Foundation Trust London United Kingdom.; Neuroscience Research Centre, Institute of Molecular and Clinical Sciences St. George's University of London London UK., Rieder CR; Movement Disorders Unit Hospital Santa Casa de Misericórdia de Porto Alegre Porto Alegre Brazil.; Federal University of Health Sciences of Porto Alegre Porto Alegre Brazil., Velon AG; Serviço de Neurologia do Centro Hospitalar de Trás-os-Montes e Alto Douro Vila Real Portugal., Tumas V; Department of Neuroscience and Behavior Sciences, Ribeirão Preto School of Medicine University of São Paulo Ribeirão Preto Brazil., Barbosa ER; Universidade de São Paulo, Faculdade de Medicina Departamento de Neurologia, Centro de Distúrbios do Movimento São Paulo Brazil., Teive HAG; Department of Neurology Universidade Federal do Paraná Curitiba Brazil., Ferraz HB; Movement Disorders Unit Universidade Federal de São Paulo Curitiba Brazil., Rosas MJ; Serviço de Neurologia Centro Hospitalar de S. João Porto Portugal., Calado A; Serviço de Neurologia do Centro Hospitalar de Lisboa Central Lisbon Portugal., Lampreia T; Serviço de Neurologia Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental Lisbon Portugal., Simões R; Serviço de Neurologia Hospital Beatriz Ângelo Lisbon Portugal., Vila-Chã N; Serviço de Neurologia do Hospital de Santo António, Centro Hospitalar Universitário do Porto Porto Portugal., Costa MM; Serviço de Neurologia Hospital Pedro Hispano Matosinhos Portugal.; Serviço de Neurologia Hospital das Forças Armadas Porto Portugal., Rodrigues AM; Serviço de Neurologia Hospital de Braga Braga Portugal., Caniça V; CNS - Campus Neurológico Torres Vedras Portugal., Cardoso F; Movement Disorders Unit Federal University of Minas Gerais Belo Horizonte Brazil., Ferreira JJ; CNS - Campus Neurológico Torres Vedras Portugal.; Laboratory of Clinical Pharmacology, Faculty of Medicine University of Lisbon Lisbon Portugal.
Jazyk: angličtina
Zdroj: Movement disorders clinical practice [Mov Disord Clin Pract] 2023 Jul 07; Vol. 10 (8), pp. 1172-1180. Date of Electronic Publication: 2023 Jul 07 (Print Publication: 2023).
DOI: 10.1002/mdc3.13826
Abstrakt: Background: Handicap is a patient-centered measure of health status that encompasses the impact of social and physical environment on daily living, having been assessed in advanced and late-stage Parkinson's Disease (PD).
Objective: To characterize the handicap of a broader sample of patients.
Methods: A cross-sectional study of 405 PD patients during the MDS-UPDRS Portuguese validation study, using the MDS-UPDRS, Unified Dyskinesias Rating Scale, Nonmotor symptoms questionnaire, PDQ-8 and EQ-5D-3L. Handicap was measured using the London Handicap Scale (LHS).
Results: Mean age was 64.42 (±10.3) years, mean disease duration 11.30 (±6.5) years and median HY 2 (IQR, 2-3). Mean LHS was 0.652 (±0.204); "Mobility," "Occupation" and "Physical Independence" were the most affected domains. LHS was significantly worse in patients with longer disease duration, older age and increased disability. In contrast, PDQ-8 did not differentiate age groups. Handicap was significantly correlated with disease duration ( r  = -0.35), nonmotor experiences of daily living (EDL) (MDS-UPDRS-I) ( r  = -0.51), motor EDL (MDS-UPDRS-II) ( r  = -0.69), motor disability (MDS-UPDRS-III) ( r  = -0.49), axial signs of MDS-UPDRS-III ( r  = -0.55), HY ( r  = -0.44), presence of nonmotor symptoms ( r  = -0.51) and PDQ-8 index ( r  = -0.64) (all P  < 0.05). Motor EDL, MDS-UPDRS-III and PDQ-8 independently predicted Handicap (adjusted R 2  = 0.582; P  = 0.007).
Conclusions: The LHS was easily completed by patients and caregivers. Patients were mild-moderately handicapped, which was strongly determined by motor disability and its impact on EDL, and poor QoL. Despite correlated, handicap and QoL seem to differ in what they measure, and handicap may have an added value to QoL. Handicap seems to be a good measure of perceived-health status in a broad sample of PD.
(© 2023 International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
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