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Beyond Motor Symptoms: The Interplay Between Non-Motor Symptoms and Caregiver Challenges in Late-Stage Parkinson’s Disease

D. Shah, A. Kothiala, D. Christian (Ahmedabad, India)

Meeting: 2025 International Congress

Keywords: Parkinson’s, Parkinsonism, Parkinsonism dementia complex(PDC)

Category: Parkinson's Disease: Non-Motor Symptoms (non-Cognitive/ non-Psychiatric)

Objective: To assess the relationship of non-motor (neuropsychiatric (NPS)) symptoms with the severity of motor symptoms of Parkinson’s Disease (PD). And to study the impact of NPS on caregiver burden.

Background: The burden of PD has doubled in the past two decades, globally estimated at over 8.5 million in 2019 by WHO. It is a debilitating neurodegenerative disorder associated with motor symptoms and a variety of non-motor symptoms. According to studies, the quality of life of the patient deteriorates by NPS. Hence, we investigated the occurrence and intensity of depression, dementia and overall mental health with the severity of PD, as well as their relationship to the caregiver’s burden.

Method: This non-interventional, cross-sectional study was conducted in a tertiary-care hospital in India, with participants with late-stage PD who were at least 60 years old and willing to participate. Participants were rated on MDS-sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Beck’s Depression Inventory, Clinical Dementia Rating (CDR), WHO-5 well-being index and Caregiver Burden Inventory at baseline. To evaluate our hypothesis, we applied chi-square and correlation analysis through Statistical Package for the Social Sciences Software (SPSS) version 29.

Results: The mean age of the 28 participants with PD is 68.11 ± 6.25 years. Of these, 53.5% of patients fall under the 10% – 20% of the MDS-UPDRS severity range. Among the non-motor symptoms, depression (Borderline clinical n=2, 7.1%; Moderate n=2, 7.1%) and Dementia (Very Mild 17.9% n=5; Mild 7.1 % n=2) were found to be significant. Depression had a noticeable positive relationship whereas dementia did not correlate with MDS-UDRS. Additionally, the well-being of the patient was negatively impacted by PD as they needed further check-ups in 79%, n=22 of cases. Furthermore, the caregiver burden was about 32.14%, (n=9) having a strong positive correlation with MDS-UPDRS.

Conclusion: The investigation of the impact of neuropsychiatric symptoms in late-stage Parkinson’s disease produced some intriguing result. A positive relationship was found between the progression of PD in participants and the severity of depression developed and also along with the burden felt by caregivers. Such results emphasize the early detection and prevention of non-motor symptoms in PD to elevate patients’ and caregivers’ quality of life.

References: 1. World Health Organization. Launch of WHO’s Parkinson disease technical brief. 2022

2. Shivangi G., Shubha S. (2021) Non-motor symptoms in Parkinson’s disease: Opening new avenues in treatment, Current Research in Behavioral Sciences, Volume 2, 100049, ISSN 2666-5182, https://doi.org/10.1016/j.crbeha.2021.100049.

3. Heimrich, K. G., Schönenberg, A., Santos-García, D., Mir, P., Coppadis Study Group, & Prell, T. (2023). The Impact of Nonmotor Symptoms on Health-Related Quality of Life in Parkinson’s Disease: A Network Analysis Approach. Journal of clinical medicine, 12(7), 2573. https://doi.org/10.3390/jcm12072573

4. Jose, A., Bhargavan, A., Appireddy, R., Raghunath, P. S., Rajan, R., & Iype, T. (2021). Neuropsychiatric Symptoms and Caregiver’s Burden in Parkinson’s Disease Patients in a Tertiary Care Teaching Hospital in South India: A Cross-Sectional Study. Neurology India, 69(6), 1706–1710. https://doi.org/10.4103/0028-3886.333437

5. Goetz, C. G., Tilley, B. C., Shaftman, S. R., Stebbins, G. T., Fahn, S., Martinez-Martin, P., Poewe, W., Sampaio, C., Stern, M. B., Dodel, R., Dubois, B., Holloway, R., Jankovic, J., Kulisevsky, J., Lang, A. E., Lees, A., Leurgans, S., LeWitt, P. A., Nyenhuis, D., Olanow, C. W., … Movement Disorder Society UPDRS Revision Task Force (2008). Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Movement disorders : official journal of the Movement Disorder Society, 23(15), 2129–2170. https://doi.org/10.1002/mds.22340

6. Topp, C. W., Østergaard, S. D., Søndergaard, S., & Bech, P. (2015). The WHO-5 Well-Being Index: a systematic review of the literature. Psychotherapy and psychosomatics, 84(3), 167–176. https://doi.org/10.1159/000376585

To cite this abstract in AMA style:

D. Shah, A. Kothiala, D. Christian. Beyond Motor Symptoms: The Interplay Between Non-Motor Symptoms and Caregiver Challenges in Late-Stage Parkinson’s Disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/beyond-motor-symptoms-the-interplay-between-non-motor-symptoms-and-caregiver-challenges-in-late-stage-parkinsons-disease/. Accessed October 5, 2025.
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