Session Information
Date: Monday, June 20, 2016
Session Title: Quality of life/caregiver burden in movement disorders
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: The objective of this study was to assess the impact of duration of PD symptom states on quality of life (QoL) among patients with advanced PD (APD).
Background: Patients with APD experience motor fluctuation with varying duration during the course of the 24-hr day. It is important to establish the consequential impact of motor fluctuations on QoL.
Methods: Post-hoc analyses were conducted on data from a randomized, double-blind, double dummy trial comparing the efficacy of levodopa-carbidopa intestinal gel (LCIG) to optimized oral levodopa/carbidopa (control) in APD patients with motor fluctuations. Observations from baseline, week 4, 8, and 12 were analyzed in patients who completed the entire study (n=66). Duration of time spent in PD motor symptom states was examined using a 24-hour home diary and categorized into 5 off-time groups: 0 (reference), >0-2, >2-4>4-6, >6 hours; and 4 on-time with troublesome dyskinesia groups: 0 (reference), >0-0.5,>0.5-1, >1 hour respectively. QoL was measured using Parkinson’s disease Questionnaire (PDQ-39) summary index score. A generalized linear mixed model was fitted with the PDQ-39 (higher score = worse) as the dependent variable to determine the effect of PD symptom states (off-time and troublesome dyskinesia) on QoL. The model was adjusted for baseline characteristics such as age, gender and H&Y score.
Results: Increasing duration of off-time was associated with declining QoL: >0-2 hours (β = 4.95, p=0.14); >2-4 hours (β = 6.10, p=0.07); >4-6 hours (β = 11.13, p=0.0008) and > 6 hours (β = 12.98, p=0.0001). Adjusting for baseline covariates and off-time, >1 hour of on-time with troublesome dyskinesia decreased QoL (β = 5.07, p=0.005). Mean off-time significantly reduced for the LCIG group compared with the control group from baseline to end of 12 weeks (4.04 hours versus 2.14 hours) respectively.
Conclusions: Increasing duration of off-time and troublesome dyskinesias are associated with poor QOL in APD. Treatment with LCIG reduces off-time which may lead to significant increase in QOL in APD patients.
To cite this abstract in AMA style:
Y. Jalundhwala, P. Kandukuri, T. Marshall, A. Yucel, K. Chatamra, K. Sail. Assessing the impact of PD motor symptom states on quality of life in patients with advanced Parkinson’s disease [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/assessing-the-impact-of-pd-motor-symptom-states-on-quality-of-life-in-patients-with-advanced-parkinsons-disease/. Accessed June 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/assessing-the-impact-of-pd-motor-symptom-states-on-quality-of-life-in-patients-with-advanced-parkinsons-disease/