Objective: To investigate whether individual non-motor symptoms (NMSs) are associated with overall NMS or quality of life (QOL) in Parkinson’s disease (PD).
Background: Worsening motor symptoms are associated with deteriorations in QOL in PD. Few studies have examined whether NMS, particularly cognitive/mental functions, predict worsening of QOL. Identifying the NMSs that influence QOL would be therapeutically advantageous.
Method: We used data from J-FIRST, a 52-week study of patients with PD, ≥1 NMS, and wearing-off under levodopa treatment, to assess the changes in Movement Disorders Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part I and 8-item PD Questionnaire (PDQ-8) total scores according to NMSs present at baseline (BL). MDS-UPDRS Part I subitem scores at BL were used to assess the presence (score ≥1) or absence (score =0) of each NMS. Cluster analysis was used to detect relationships among NMSs.
Results: The analyses comprised 996 patients (62.7% female) with mean ± standard deviation age of 68.1±8.8 years. MDS-UPDRS Part I and PDQ-8 total scores at BL were 10.9±5.4 and 7.3±5.2, respectively. The MDS-UPDRS Part I total score worsened in patients with cognitive impairment, depressed mood, or apathy, but improved in those with features of dopamine dysregulation syndrome (DDS) at BL vs patients without these NMSs [Figure1]. The PDQ-8 total score worsened in patients with cognitive impairment, hallucinations and psychosis, depressed mood, apathy, pain and other sensations, urinary problems, and fatigue at BL vs patients without these NMSs [Figure2]. Cluster analysis revealed two broad clusters of NMSs; one was related to cognitive/mental functions (depressed mood, anxious mood, apathy, cognitive impairment, hallucinations and psychosis, and DDS); the other was related to physiological functions (sleep problems, daytime sleepiness, constipation problems, and urinary problems). Lightheadedness on standing, fatigue, and pain and other sensations were closely related.
Conclusion: Overall NMSs and QOL were worse in patients with NMSs related to cognitive/mental functions. QOL was worse in patients with NMSs related to physiological functions. Optimal management of these NMSs may reduce the worsening of NMSs and QOL.
To cite this abstract in AMA style:
K. Kashihara, S. Chiu, Y. Tsuboi, N. Hattori, M. Nomoto, H. Watanabe, T. Maeda, H. Saiki, Y. Shimo, T. Yamaguchi. Factors associated with progression of Parkinson’s disease and deterioration in quality of life: Results of J-FIRST, a 1-year observational study [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/factors-associated-with-progression-of-parkinsons-disease-and-deterioration-in-quality-of-life-results-of-j-first-a-1-year-observational-study/. Accessed June 15, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/factors-associated-with-progression-of-parkinsons-disease-and-deterioration-in-quality-of-life-results-of-j-first-a-1-year-observational-study/