Citation

van Uem JMT, Cerff B, Kampmeyer M, Prinzen J, Zuidema M, Hobert MA, Gräber S, Berg D, Maetzler W, Liepelt-Scarfone I. Parkinsonism Relat. Disord. 2018; 48: 74-81.

Affiliation

Center for Neurology, Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany; DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.parkreldis.2017.12.023

PMID

29307560

Abstract

BACKGROUND: Lower levels of physical activity are associated with lower Health-Related Quality of Life (HRQoL) in Parkinson's disease (PD). We evaluated the influence of quantitative physical activity parameters among other (disease-related) features representing other domains of the WHO International model for classification of Function, Disability, and Health (ICF) on HRQoL in PD.

METHODS: Home-based movement data (DynaPort MiniMod®) was collected in 47 PD patients. Nine stepwise regression models were calculated, with consecutive outcome variables: Parkinson's Disease Questionnaire (PDQ) Summary Index (SI), PDQ-Mobility, PDQ-Activities of Daily Living (ADL). Demographic variables, disease-specific features, and quantitative physical activity parameters, were included as predicting variables in all analyses. The following three physical activity parameters were alternately included for both sedentary and active episodes: 'percentage' of 24 h spent within these episodes, 'number of bouts', and 'mean bout lengths' (MBL).

RESULTS: Depression and 'Total Energy Expenditure' were the main predictors of overall HRQoL (PDQ-SI), independent of the permutation of activity parameters. The same parameters predicted the PDQ-Mobility score. However, this result was altered when 'MBL' parameters were included into the model, 'MBL' of sedentary episodes additionally predicted HRQoL-Mobility. The PDQ-ADL score was associated with demographic, motor, and non-motor variables including cognitive status. After exclusion of demented PD patients, older age and cognitive impairment no longer constrained HRQoL-ADL.

DISCUSSION: For the first time, we showed the influence of objective, home-based measured physical activity among depression and cognition on HRQoL in PD. This suggests that a multifactorial treatment approach would be most successful to increase HRQoL in PD.

Copyright © 2017. Published by Elsevier Ltd.

Language: en

Keywords

Activities of daily living; Cognition; Health-related quality of life; Home environment; Parkinson's disease; Wearables