Abstract
BACKGROUND: Young onset Parkinson's disease (YOPD) is a distinct entity from typical late onset Parkinson's disease (LOPD). The influene of non-motor features on the health - related quality of life (HRQoL) in LOPD has been previously reported, but little is known about the impact of non-motor features in YOPD. OBJECTIVE: The aim of this study was to explore the relationship between non-motor burden and HRQoL in patients with YOPD. METHODS: This was an observational, cross-sectional study in patients with a PD, whose age at disease onset ranged from 21 to 40 years (YOPD). Participants were assessed with the MDS Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS) and the 39-item Parkinson's Disease Questionnaire (PDQ-39; range 0-100). Spearman's rank test was used to identify correlations between NMSS domains and several dimension of HRQoL. Stepwise multiple linear regression analysis was performed to identify the independent predictors of HRQoL as measured by PDQ-39 summary index. RESULTS: 89 patients with YOPD mean (SD) age = 42.15 (5.84) participated. Patients reported 10.17 (4.74) non-motor symptoms, the most common (75%) and severe (median = 3) of which was was fatigue (IQR = 7). The most frequently reported and severely affected NMSS domain was sleep/fatigue (89.9%, median = 8; IQR = 13) followed by mood/cognition (83.1%, median = 6; IQR = 18) and attention/memory (82%, median = 5; IQR = 8). The mean (SD) summary index of PDQ-39 was 32.89 (16.8). The means (SD) of each PDQ-39 dimensions were: mobility 37.33 (21.96), ADL 42.93 (25.33), emotional well-being 39.77 (25.47), stigma 38.19 (28.44), social support 19.03 (22.89), cognition 29.59 (20.63), communication 26.96 (23.57), and bodily discomfort 29.96 (23.19). With the exception of gastrointestinal tract and sexual function, all other NMSS domain scores were correlated with the PDQ-39 summary index. The multivariate model revealed that three NMSS domains including sleep/fatigue, mood/cognition and attention/memory accompanied with UPDRS part III were independent predictors of HRQoL as measured by PDQ-39SI. CONCLUSIONS: Non-motor symptoms pertaining to sleep disturbances/fatigue, mood/cognition and attention/memory negatively impact HRQoL in patients with YOPD.