Factors influencing quality of life in Chinese patients with dementia: a systematic review

Background:Dementia is a group of nervous system diseases characterized by progressive cognitive decline,leading to a loss of self-care ability and a decline in well-being.This places a significant burden on the global healthcare system,with Chinese patients accounting for approximately one-quarter of the world’s dementia cases.Therefore,it is crucial to identify factors that impact the quality of life(QOL)among elderly Chinese individuals with dementia.Method:To achieve this,we conducted a comprehensive search of several databases,including PubMed,Embase,Web of Science,the Cochrane Library,China National Knowledge Infrastructure,Wanfang Data,China VIP Database and China Biomedical Literature Database.We reviewed cross-sectional studies from the inception of these databases until March 27,2022.QOL outcomes were assessed using standardized scales in the studies included in this review.Results:The search yielded a total of 1,235 relevant articles,from which we finally included 21 cross-sectional studies and one longitudinal study after rigorous quality assessment.Among these,10 studies were classified as high quality,while 12 were classified as fair quality.Through our analysis,we identified 28 patient-rated QOL factors and 14 caregiver-rated QOL factors.These factors were categorized into three groups:patient,disease-related and caregiver.Factors commonly found to influence patient-rated QOL included age,education,marital status,depression,self-care ability,dementia severity,cognitive function,behavioral and psychological symptoms of dementia and caregiver burden.Similarly,factors commonly influencing caregiver-rated QOL included economic status,depression,self-care ability,dementia severity,cognitive function,behavioral and psychological symptoms of dementia and caregiving time.Conclusion:This review clarifies the factors that influence the QOL of Chinese individuals with dementia.When implementing interventions,it is crucial to consider the differences between patient-rated QOL and caregiver-proxy-rated QOL,as well as their respective influencing factors.

Life′s Simple 7干预减轻Her⁃2阳性乳腺癌患者化疗相关心血管系统损害的研究

目的探讨Life′s Simple 7(LS7)干预减轻Her⁃2阳性乳腺癌患者根治术后化疗相关心血管系统损害的作用。方法将120例Her⁃2阳性并接受标准化乳腺癌化疗的患者随机等量分为对照组及LS7组,对照组为标准化疗方案,LS7组为对照组基础上给予LS7干预12个月,后续通过比较两组治疗前后心血管系统损伤程度、焦虑、抑郁及生活质量等指标评价其对心血管系统损害的改善作用。结果相较于对照组,LS7组LS7总评分及7项心血管健康指标均优于对照组(P<0.05),LS7组LVEF较高(P<0.05)、NT⁃proBNP较低(P<0.05),焦虑和抑郁评分较低(P<0.05)、生活质量评分较高(P<0.05)。结论LS7干预可显著减轻Her⁃2阳性乳腺癌化疗相关心血管系统损害并改善乳腺癌患者的心理状况和生活质量,值得在临床推广。

Faecal incontinence and health related quality of life in inflammatory bowel disease patients: Findings from a tertiary care center in South Asia

AIM: To analyze the frequency and severity of faecal incontinence(FI) and its effect on the quality of life(QOL) in inflammatory bowel disease(IBD) patients. METHODS: All patients who attended surgical and medical gastroenterology outpatient clinics in a tertiary care center with an established diagnosis of either ulcerative colitis(UC) or Crohn's disease(CD) over a period of 10 mo were included in this study. Before enrollment into the study, the patients were explained about the study and informed consent was obtained. The patients with unidentified colitis were excluded. The data on demographics, disease characteristics, FI(Vaizey score), and quality of life(IBD-Q) were collected. Data were analyzed using SPSS version 21.RESULTS: There were 184 patients(women = 101, 54.9%; UC = 153, 83.2%) with a female preponderance for UC(male/female ratio = 1:1.5) and a male preponderance for CD(male/female = 2:1). Forty-eight(26%) patients reported symptoms of FI. Among the patients with FI, 70.8% were women(n = 34) and 29.2% were men(n = 14) with an average age of 52.7 years(range, 20-78 years). Average age of onset of FI was 48.6(range, 22-74) years. Ten percent(n = 5) reported regular FI. Incontinence to flatus was seen in 33.3%(n = 16), to liquid faeces in 56.2%(n = 27), to solid faeces in 6.2%(n = 3) and to all three in 4.1%(n = 2). Twenty-one percent(n = 10) complained of disruption of their physical and social activity. There was no association between FI and type of IBD. Significant associations were found between FI and age(P = 0.005) and gender(P < 0.001). QOL in our cohort of patients was significantly affected by FI.CONCLUSION: In our study, nearly a quarter of patients reported FI. There was a significant correlation between FI and QOL. Therefore, enquiring about FI in IBD patients can lead to identification of this debilitating condition. This will enable early referral for continence care in this group of patients.

Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil

BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil.

Addressing quality of life in the patient with interstitial cystitis/bladder pain syndrome

Interstitial cystitis/bladder pain syndrome(IC/BPS)is a debilitating,chronic condition characterized by chronic pelvic pain,urinary urgency,and frequency and is well-known to be associated with a decrease in work productivity,emotional changes,sleep,sexual dysfunction,and mobility.Many metrics of quality of life(QoL)in this patient population have been developed;however,a unified,standardized approach to QoL in these patients has not been determined.The effects of IC/BPS and co-morbid conditions on QoL are described using current validated metrics.Next,data regarding successful treatment of IC/BPS in terms of QoL improvement are reviewed.While QoL is the single most important clinical measure of success in the treatment of patients suffering from IC/BPS,addressing QoL in this patient population remains a significant challenge,as its effects on QoL are highly variable and unable to be differentiated from the effects of comorbid conditions on QoL,including depression,poor sleep,and inability to work.Future studies will need to address treatment efficacy on the basis of IC/BPS specific QoL metrics,and multi-modal assessment and therapy to address comorbid disease will also play an important role in the future to ensure comprehensive management of these patients.

Association between Caregiver Quality of Life and the Care Provided to Persons with Alzheimer’s Disease: Systematic Review

We reviewed the literature to examine whether an association exists between the quality of life (QoL) of primary informal Alzheimer's disease (AD) caregivers and the level and quality of care that these caregivers provide to their loved ones with AD. We obtained studies focusing on the care that these caregivers provide for their family members with AD. Our outcome of interest was level or quality of care and the independent variable was caregiver QoL. We extracted data in tabular form and used a narrative synthesis approach to describe our findings. Only one relevant study was included in the review. Overall, the evidence was equivocal regarding the associations between caregiver QoL and the level/quality of care in AD.

Higher vitamin D serum concentration increases health related quality of life in patients with inflammatory bowel diseases

AIM: To investigate the effect of vitamin D(VD) concentrations and VD supplementation on health related quality of life in inflammatory bowel disease(IBD) patients. METHODS: A cohort of 220 IBD patients including 141 Crohn's disease(CD) and 79 ulcerative colitis(UC) patients was followed-up at a tertiary IBD center. A subgroup of the cohort(n = 26) took VD supplements for > 3 mo. Health related quality of life was assessed using the short IBD questionnaire(s IBDQ). VD serum concentration and s IBDQ score were assessed between August and October 2012(summer/autumn period) and between February and April 2013(winter/spring period). The mean VD serum concentration and its correlation with disease activity of CD were determined for each season separately. In a subgroup of patients, the effects of VD supplementation on winter VD serum concentration, change in VD serum concentration from summer to winter, and winter s IBDQ score were analyzed.RESULTS: During the summer/autumn and the winter/spring period, 28% and 42% of IBD patients were VD-deficient(< 20 ng/m L), respectively. In the winter/spring period, there was a significant correlation between s IBDQ score and VD serum concentration in UC patients(r = 0.35, P = 0.02), with a trend towards significance in CD patients(r = 0.17, P = 0.06). In the winter/spring period, VD-insufficient patients(< 30 ng/m L) had a significantly lower mean s IBDQ score than VD-sufficient patients; this was true of both UC(48.3 ± 2.3 vs 56.7 ± 3.4, P = 0.04) and CD(55.7 ± 1.25 vs 60.8 ± 2.14, P = 0.04) patients. In all analyzed scenarios(UC/CD, the summer/autumn period and the winter/spring period), health related quality of life was the highest in patients with VD serum concentrations of 50-59 ng/m L. Supplementation with a median of 800 IU/d VD day did not influence VD serum concentration or the s IBDQ score.CONCLUSION: VD serum concentration correlated with health related quality of life in UC and CD patients during the winter/spring period.

Health-related quality of life in Parkinson's disease patients in northeastern Sicily, Italy An ecological perspective

Parkinson＇s disease has a negative impact on health-related quality of life in Parkinson＇s disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson＇s disease patients in nOrtheastern Sicily, Italy. Ninety Parkinson＇s disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi ＂Bonino-Pulejo＂ （Messina）, were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale （UPDRS-Ⅲ） scores, the Parkinson Disease Questionnaire-39 Item scores （as a disease-specific measure of health-related quality of life）, scores on the Short Form （36） Health Survey Questionnaire （as a generic measure）, and answers to a brief checklist were recorded. A total of 85 Parkinson＇s disease patients （49% males and 51% females; mean age 70.8 ± 8.6 years mean UPDRS-Ⅲ 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years） completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.

Virtual games and quality of life in Parkinson’s disease: A randomised controlled trial

Objective: To evaluate the efficacy of Nintendo Wii training in quality of life in Parkinson’s disease (PD) patients when compared to traditional physical therapy (PT). Methods: A randomized, single-blinded trial with 2 parallel arms was performed in a referral center for movement disorders in North-eastern, Brazil. Forty-four PD outpatients that fulfilled the eligibility criteria with mild to moderate motor impairment were randomized. Both groups executed a warm up session for 10 minutes that consisted of trunk flexion, extension and rotation, associated with upper and lower limbs stretching. The PT group followed a program that consisted of trunk and limb mobilisation, balance, muscle strengthening, rhythmic movement, postural alignment, double-task execution, bimanual tasks, and gait training. The Nintendo Wii group executed a sequence of tasks according to a previously established protocol, with similar training exercises. Duration of exercises was 40 minutes per session, 3 days per week for 4 weeks. The primary endpoint was the total score obtained in the Parkinson’s disease quality of life questionnaire (PDQ-39) translated from English to Brazilian Portuguese by Oxford outcomes. Secondary endpoints were the scores achieved by each group in the following domains of PDQ-39 scale: mobility, activities of daily living (ADL), emotional well-being, stigma, social support, cognition, communication and bodily discomfort. Assessments were performed before and after intervention in both groups with subjects in the “on” period. Results: Subjects in the Nintendo Wii group showed greater improvement in the PDQ-39 total score when compared to PT group (p = 0.01). Also, significant differences were observed in ADL, stigma, social support and communication when comparing subjects before and after intervention in the Nintendo Wii group (p < 0.05). Conclusions: The results achieved in this trial suggest that rehabilitation using Nintendo Wii may have beneficial effects in quality of life of PD subjects, when compared to traditional PT. Further larger randomised controlled-trials are necessary to reassure these results.

Estimation of quality of life in Cypriot patients with inflammatory bowel disease

AIM To investigate the health-related quality of life(HRQoL)of patients suffering with idiopathic inflammatory bowel disease(IBD).METHODS The Greek validated version of the Short Inflammatory Bowel Disease Questionnaire was used for evaluating the quality of life of IBD patients.The questionnaire was distributed to 100 consecutive patients suffering from IBD and presenting for a clinic appointment at the endoscopy unit of Larnaca General Hospital during the period from October to November 2012.The criteria for participating in this study were constituted by the documented diagnosis of either ulcerative colitis(UC)or Crohn’s disease(CD)after endoscopy and histologic examination at least 6 months before the study,adult patients(18 years old or older),the capability of verbal communication and the patient’s written consent for attending this study.The majority of the questionnaires were completed by a nurse practitioner who specializesin IBD patient care.RESULTS Regarding the physical dimension in patients with UC,males scored significantly higher than females(4.2 vs3.4,P=0.023).Higher scores were also observed in UC patients younger than 35 or older than 50 years(4.0 and 4.2 vs 3.2,respectively,P=0.021).The psychological dimension revealed similar results in patients with UC,with males,and older ages scoring higher(5.0 vs 3.0,P=0.01 and 4.7 vs 2.7,P<0.5,respectively),whereas regarding CD higher scores were observed in married compared to unmarried(3.83vs 2.33,P=0.042).No statistical differences in any parameters in the social dimension were observed.Regarding the treatment of,patients with CD,overall higher scores were observed when treated with biological factors compared to standard therapy in all dimensions but with statistical significant difference in the social dimension(5.00 vs 3.25,P=0.045).CONCLUSION The study reveals a negative impact of IBD on HRQo L.Increased risks are age and gender in patients with UC and family status in patients with CD.

Effect of Abnormal Posture on Quality of Life in Patients with Parkinson’s Disease

Background: Relationship between abnormal posture and QOL of Parkinson's disease is not clear. Objectives: To clarify the association between quality of life (QOL) and abnormal posture in patients with Parkinson’s disease (PD) and examine which QOL dimensions are involved. Methods: This study retrospectively examined PD patients (n = 57) who had undergone outpatient rehabilitation between January and March 2014. Evaluation items were Modified Hoehn Yahr (H-Y) stage, Unified Parkinson’s Disease Rating Scale (UPDRS)-Part III score, Timed Up and Go test (TUG, 3-m walking) result, Parkinson’s Disease Questionnaire (PDQ)-39 score, and the angle of forward and lateral trunk flexion in the standing position. Statistical analysis was performed to reveal the relationship between the total PDQ-39 score and individual evaluation items and which QOL dimensions were affected by abnormal posture due to forward or lateral flexion. Results: A total of 38 PD patients (17 men, 21 women;mean age, 73.2 ± 8.6 years) were enrolled. Among the evaluation items, lateral flexion angle showed a significant correlation with the total PDQ-39 score (r = 0.422, P = 0.008). PDQ-39 dimensions showing an association with forward flexion were activities of daily living (ADL) (P = 0.002) and communication (P = 0.007), whereas ADL (P = 0.004), communication (P = 0.021), and social support (P = 0.029) were associated with lateral flexion. Mobility was not associated with forward or lateral flexion. Conclusion: The present findings revealed a correlation between lateral flexion and QOL in PD patients. Among the PDQ-39 dimensions, ADL and communication were associated with abnormal posture.

Outcomes of Quality of Life Regarding the Next-Generation Thoracoscopic Intrapleural Hyperthermic Chemotherapy of Non-Small Cell Lung Cancer with Dissemination

Background: We have developed a new next-generation intrapleural hyperthermic chemotherapy (IPHC) for non-small cell lung cancer with dissemination, which is a hybrid chemotherapy combined with oral S-1 medication plus conventional cisplatin-based IPHC. We now report the preliminary feasibility and outcome of quality of life (QOL) regarding this hybrid IPHC. Methods: The patient was a 76-year-old male with a 2-cm nodule in the left upper lobe. After partial resection by video-assisted thoracic surgery (VATS), which was diagnosed with advanced pulmonary adenocarcinoma with intrapleural dissemination. We initially performed two regimens of systemic chemotherapy, S-1 (day 1 - 21, 100 mg 2X/day) + CDDP (day 8, 60 mg/m2) and S-1 (day 1 - 14,100 mg 2X/day) + CBDCA (day 1, AUC 5). The regimen of next-generation IPHC is oral S-1 medication (day 1 - 21, 100 mg/day) + intrapleural hyperthermic perfusion of cisplatin (200 mg/m2) with VATS (day 8,43°C, 2 hours). Adverse outcomes, QOL, and pleural effusion were assessed in three regimens. To investigate the outcomes of the QOL, the European Organization for Research and Treatment of Cancer QOL Questionnaire (EORTC QLQ-C30 and QLQ-LC13), the QOL questionnaire for cancer patients treated with anticancer drugs (QOL-ACD), the Cancer Dyspnea Score (CDS), and the St. George’s Respiratory Questionnaire (SGRQ) were used. Results: During the IPHC treatment course, grade 3 neutropenia, anemia, and diarrhea were observed. The physical function after IPHC became worse compared to that before the IPHC. Fatigue during chemotherapy (CBDCA+S-1) was more pronounced than that during the IPHC. Nausea, vomiting, and diarrhea during the IPHC were prevalent than those of chemotherapy. The overall QOL after the IPHC was improved compared to that before the IPHC. Regarding before and after the IPHC, the physical function after the IPHC became worse compared to that before the IPHC, on the other hand, the global QOL before and after the IPHC had not dramatically changed. Pleural effusion was controlled after the IPHC for more than 1 year. Conclusion: The first case of a clinical trial of the next-generation IPHC showed grade 3 adverse events. However, it was an acceptable feasibility compared to the usual platinum doublet chemotherapy. The effectiveness of the IPHC allowed the patient to obtain a good control of the pleural effusion and preserved the patient’s QOL.

Expectations and Level of Satisfaction of the Patient with Parkinson’s Disease Undergoing Deep Brain Stimulation Surgery at the National Institute of Neurology and Neurosurgery

Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.

Quality of life after surgery of the alimentary tract

In recent decades, patient-reported outcomes have become important in clinical medicine. Nowadays, health-related quality of life (HRQOL) is considered a primary outcome in many clinical trials, and it is often the major criterion for judging treatment success. At the beginning of the 21st century, morbidity and mortality rates after surgery of the alimentary tract have dropped dramatically and they can no longer be considered the only outcome measures to determine the success of a surgical procedure. QOL can yield a definitely more patient-orientated measure of outcome that provides us with a more formal measure of the patient’s judgment and desires, which can influence treatment decisions. Nevertheless, despite a very large number of published papers on HRQOL, there is some skepticism on the value of HRQOL and other patientrelated outcomes. Therefore, this topic highlight aims to assess how QOL after surgery of the alimentary tract is covered in the medical literature. Different reviews have analyzed the topic according to different points of view: benign and malignant disease; curative and palliative treatment; open and minimally invasive surgical approach; traditional and newly introduced surgical procedures. This topic highlight does not aim to cover all the possible diseases or different surgical procedures, but it does describe the different approaches in order to give the reader a broad spectrum of analysis of QOL after surgery. This quick overview could stimulate the reader to form his/her own opinion about how to use this primary outcome measure.

Patient Satisfaction Index and Quality of Life Measurement with Breast-Q after Breast Reconstruction in a Plastic Surgery Center in Mexico

Introduction: Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of life. BREAST-Q is a PROM (Patient Reported Outcome Measures) that has proven useful in measuring satisfaction with breast reconstruction results from the patient’s point of view. Objectives: To measure the satisfaction index and improvement in quality of life after breast reconstruction for breast cancer sequelae in our hospital in the last 5 years. Materials and Methods: Descriptive Study that includes patients with Breast cancer diagnosis that underwent mastectomy and breast reconstruction (prosthesis or autologous tissue) in “Hospital Central Sur de Petroleos Mexicanos” (January 2015 to January 2020), whose satisfaction index was measured with BREAST-Q one year after reconstruction. Results: 153 patients were included in the analysis. Mean global satisfaction was 74 points. We observed a tendency towards higher psychosocial, sexual and appearance satisfaction in patients who underwent reconstruction with autologous tissue. The mean satisfaction with provided information was 64 points and with the medical team > 90 points. Conclusion: Breast reconstruction is associated to a high satisfaction index and quality of life improvement regardless of the technique. BREAST-Q proved to be useful in evaluating patient experience and it helped us identify areas of opportunity to improve our care.

Safety and Efficacy of a Transdermal Rotigotine for the Treatment of Fatigue and Quality of Life in Patients with Parkinson’s Disease

Aim: To evaluate safety and efficacy of a transdermal rotigotine for the treatment of fatigue and quality of life (QOL) in patients with Parkinson’s disease (PD). This was a multi-sites open-label study of 58 PD patients (male 26, female 32) who met a Japanese PD diagnosis criterion. They received a transdermal rotigotine 4.5 mg/day for 8 weeks. We added a rotigotine on the previous anti-Parkinson’s drugs. Clinical signs were evaluated by Hoehn-Yahr (H-Y) stage, unified Parkinson’s disease rating scale (UPDRS), fatigue severity scale (FSS), and Euro quality of life (QOL). The scores of UPDRS improved from 35.2 ± 8.0 (mean ± SD) to 31.8 ± 8.3 (P = 0.14). There was no significant improvement or worsening of the H-Y stages. The scores of FSS improved from 57.3 ± 12.7 (mean ± SD) to 50.1 ± 11.8 (P = 0.061). The scores of QOL improved from 38.1 ± 11.1 to 48.3 ± 10.0 (P = 0.068). Our data demonstrate that, in a small sample size, administration of a transdermal rotigotine was associated with few side effects and was modestly effective for the treatment of fatigue and QOL in patients with PD.

Effectiveness of Istradefylline for Fatigue and Quality of Life in Parkinson’s Disease Patients’ and of Their Caregivers’

Objectives: We evaluated efficacy and safety of istradefylline that is the first selective adenosine A2A receptor antagonist, for the treatment of non-motor symptoms and quality of life (QoL) in Parkinson’s disease (PD) patients with and QoL in their caregivers. Methods: This was a multisites study of 40 PD patients (female 24, male 16) who fully filled UK PD society brain bank clinical diagnostic criteria. They received istradefylline 20 mg/day for 8 weeks. We added istradefylline on the previous anti-Parkinson’s drugs. Clinical severities were evaluated by Hoehn-Yahr (H-Y) stage, unified PD rating scale (UPDRS), non-motor symptoms in PD (NMSPD), fatigue severity scale (FSS) and Euro QoL. Also, we evaluated their caregiver’s QoL by Euro QoL. Results: The scores of UPDRS part I improved from 1.3 ± 1.1 to 06 ± 0.9 (P = 0.18), part II improved from 11.9 ± 3.2 to 11.0 ± 3.1 (P = 0.17), part III improved from 34.8 ± 7.2 to 32.1 ± 8.3 (P = 0.105). There was no significant improvement or worsening of the H-Y stages. The scores of NMSPD improved from 49.9 ± 11.2 to 43.9 ± 10.6 (P = 0.08). The scores of FSS improved from 62.8 ± 7.1 to 52.3 ± 9.3 (P = 0.049). The total scores of Euro QoL in PD patients improved from 48.8 ± 14.9 to 57.2 ± 13.0 (P = 0.045). The total scores of Euro QoL in patients’ caregivers improved from 54.2 ± 11.0 to 59.8 ± 10.9 (P = 0.046). Conclusions: Our data demonstrated that istradefylline was associated with few side effects and was modestly effective for the treatment of non-motor symptoms especially fatigue that might improve QoL in PD patients as well as in their caregivers’.

The Quality of Life for People with Parkinson’s Disease in Relation to Their Oral Health

The present study aimed to evaluate the correlation between the oral health status and the quality of life for people with Parkinson’s disease. The Decayed, Missing, Filled (DMFT) index and the quality of life questionnaire for people with Parkinson’s disease (Parkinson’s Disease Questionnaire-39) were used as evaluation instruments. Sixty-two people with a clinical diagnosis of Parkinson’s disease between stages 1 and 3, age between 46 and 86 years, of both sexes, with an average time of disease evolution of 7 years, participated in the study. Data were evaluated using the Pearson’s correlation test, and one-way ANOVA (p < 0.05). The mean DMFT obtained was 23;there was no correlation between the DMFT values and the total score of the Parkinson’s Disease Questionnaire-39 neither in its domains, nor between the DMFT and the stages of Parkinson’s disease (p = 0.61). We found that the oral health of parkinsonians is deficient due to the high number of missing teeth, but their perception of quality of life is favorable despite their motor limitations related to mobility, and activities of daily living.

Sex modulates the outcome of subthalamic nucleus deep brain stimulation in patients with Parkinson's disease

There are many documented sex differences in the clinical course,symptom expression profile,and treatment response of Parkinson’s disease,creating additional challenges for patient management.Although subthalamic nucleus deep brain stimulation is an established therapy for Parkinson’s disease,the effects of sex on treatment outcome are still unclear.The aim of this retrospective observational study,was to examine sex differences in motor symptoms,nonmotor symptoms,and quality of life after subthalamic nucleus deep brain stimulation.Outcome measures were evaluated at 1 and 12 months post-operation in 90 patients with Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation aged 63.00±8.01 years(55 men and 35 women).Outcomes of clinical evaluations were compared between sexes via a Student’s t-test and within sex via a paired-sample t-test,and generalized linear models were established to identify factors associated with treatment efficacy and intensity for each sex.We found that subthalamic nucleus deep brain stimulation could improve motor symptoms in men but not women in the on-medication condition at 1 and 12 months post-operation.Restless legs syndrome was alleviated to a greater extent in men than in women.Women demonstrated poorer quality of life at baseline and achieved less improvement of quality of life than men after subthalamic nucleus deep brain stimulation.Furthermore,Hoehn-Yahr stage was positively correlated with the treatment response in men,while levodopa equivalent dose at 12 months post-operation was negatively correlated with motor improvement in women.In conclusion,women received less benefit from subthalamic nucleus deep brain stimulation than men in terms of motor symptoms,non-motor symptoms,and quality of life.We found sex-specific factors,i.e.,Hoehn-Yahr stage and levodopa equivalent dose,that were related to motor improvements.These findings may help to guide subthalamic nucleus deep brain stimulation patient selection,prognosis,and stimulation programming for optimal therapeutic efficacy in Parkinson’s disease.