Impact of the motor complications of Parkinson's disease on the quality of life

Abstract

The impact of motor complications of Parkinson's disease (PD), especially levodopa‐induced dyskinesias, on quality of life (QL) was studied in 143 patients with PD. All were evaluated on the Hoehn and Yahr (H&Y) scale, and the Motor part of the Unified Parkinson's Disease Rating Scale (UPDRS). Motor complications were analyzed using the UPDRS Parts IV_A and IV_B and the Abnormal Involuntary Movement Scale. A specific Parkinson's disease quality of life questionnaire (39‐item version, PDQ‐39) was used. Motor complications significantly worsened the PDQ‐39 Summary Index (PDQ‐SI) of patients with PD. The dimensions of Mobility, Activities of Daily Living, Stigma, and Communication were the most strongly affected. “Peak dose” dyskinesia decreased Mobility, Emotional Well‐Being, and Cognition, whereas biphasic dyskinesia affected Mobility, Stigma, Communication, and Activities of Daily Living. Morning akinesia, end‐of‐dose fluctuations, and “unpredictable offs” decreased QL on the dimensions of Mobility, Activities of Daily Living, Stigma, and Communication. Nocturnal akinesia led to a deterioration of all dimensions of the PDQ‐39. Thus, motor complications and especially nocturnal akinesia and biphasic dyskinesias worsened the QL of PD patients. © 2004 Movement Disorder Society