Aims and objectives
To identify the personal‐ and disease‐related factors that are associated with living with Parkinson's disease.
Background
Living with Parkinson's disease affects the physical, ...psychological, social and spiritual areas of the person. Health professionals need to know which factors influence the daily living with Parkinson's disease, in order to facilitate a positive living.
Design
A multicentre cross‐sectional study.
Methods
A total of 324 patients with Parkinson's disease diagnoses were included in the study through a consecutive case sampling. Data were collected from January–June 2015, in specialised units of movement disorders of public and private and community centres, from Spain, Argentina, Mexico, Ecuador and Cuba. Nine measures were applied to evaluate personal‐related factors (age, gender, psychosocial function, satisfaction with life, social support, home economical situation) and Parkinson's disease‐related factors (duration of disease, motor symptoms and non‐motor symptoms). The STROBE checklist was used to ensure quality reporting during the study (see File S1). Multiple linear regression analysis was carried out.
Results
Results indicated that social support, followed by satisfaction with life and home economical situation are the only three factors that significantly influence in living with Parkinson’s disease. The rest of the factors analysed did not present significant influence in the daily living with this neurodegenerative disease.
Conclusion
This study highlights the necessity to put more emphasis on the person and his/her daily living with the condition and less on symptoms and treatment. Health professionals need to develop person‐centred interventions that also deal with other elements of the experience of living with a long‐term condition like Parkinson's disease.
Relevance to clinical practice
Interventions to foster positive living with Parkinson's disease in clinical practice should integrate strategies to tackle and prevent loneliness and interagency elements to increase community resources and systems of support.
Background
Non‐motor symptoms (NMS) are frequent in Parkinson's disease (PD).
Objectives
To estimate the prevalence of NMS and of non‐motor fluctuations (NMF) using the Movement Disorders ...Society‐Non‐Motor Rating Scale (MDS‐NMS) and other scales assessing NMS, and their relationship with sex and PD severity.
Methods
Cross‐sectional study with a sample of 402 PD patients. The Hoehn and Yahr staging system (HY), Clinical Impression of Severity Index for PD (CISI‐PD), MDS‐NMS (including NMF‐ subscale), Non‐Motor Symptoms scale (NMSS), and MDS‐Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) were applied. A NMS was considered present when scored ≥1. Differences in scores by sex and HY, CISI‐PD, and MDS‐UPDRS severity levels were calculated using Fisher's exact and chi‐squared tests.
Results
Using the MDS‐NMS, NMS were present in 99.7% of patients and the mean number of NMS was 16.13 (SD: 9.36). The most prevalent NMS was muscle, joint or back pain (67.4% of the sample) and the least prevalent was dopamine dysregulation syndrome (2.2%). Feeling sad or depressed was significantly more prevalent in women. Using the MDS‐NMS revealed more NMS than the other scales assessing NMS. NMF were present in 41% of the sample, with fatigue being the most prevalent symptom (68.5% patients with NMF), and no differences by sex. Patients with greater PD severity had higher prevalence of NMS than patients with lower severity.
Conclusions
Almost all patients with PD experience NMS, and many experience NMF. Prevalence rates for NMS using the MDS‐NMS are higher than on other scales used and increase with higher disease severity.
Background
Heavy drinking (HD) and binge drinking (BD) exhibit marked differences in their relationships with contextual‐level factors imbedded in geographical areas of residence. The objective is to ...identify sociodemographic factors, both at the individual and at the contextual level, associated with these 2 main hazardous consumption patterns.
Methods
Cross‐sectional study using data from the 2011 to 2012 National Health Survey in Spain. The sample included 21,007 individuals ≥15 years of age. HD was defined as an alcohol intake of ≥40 g/d in men and ≥24 g/d in women. BD was defined as the consumption in the previous month of ≥6 alcoholic drinks (men) or ≥5 drinks (women) within 4 to 6 hours. Individual‐level variables included sociodemographic factors, urban/rural residence, smoking, and perceived social support. Contextual‐level variables covered percentage of population with no schooling, unemployment rate, and hospitality industry‐related economic activity, all at the census tract level. We analyzed data using multilevel logistic regression and calculated areas under the curve (AUC).
Results
Being male, smoking, high‐income, and low perceived social support were associated with both hazardous drinking patterns. Younger individuals were at higher risk for BD but at lower risk for HD. BD was more common among rural than urban dwellers (odds ratios OR = 1.35; 95% CI: 1.05 to 1.72), whereas HD was less likely in participants residing in areas with high unemployment rates (OR = 0.62; 95% CI: 0.41 to 0.93). HD was more likely in census tracts with higher levels of hospitality industry activity (OR = 1.74; 95% CI: 1.20 to 2.54). The AUC increased substantially for both HD and BD when the census tract variable was entered in the respective models (reaching 89.5 and 93.3%, respectively).
Conclusions
Except for age, both drinking patterns have similar associations with individual‐level variables but disparate links to contextual‐level indicators. In both cases, accounting for area of residence substantially increased the ability to discriminate between high‐risk drinkers from nonhazardous alcohol consumers.
It is not clear to what extent some environmental conditions predict dangerous drinking. The data show that individuals who perceived their social support as low were around twice as likely to report heavy and binge drinking. Residents of areas with high employment in the hospitality industry were more likely to report heavy drinking, while areas of higher unemployment had fewer heavy drinkers. Binge drinking was more common among rural residents. Some environmental conditions may help to identify individuals at risk.
This study focuses on the influence of anxiety and depression on individual trajectories of quality of life in old age through a longitudinal approach. A representative sample of adults aged 50+ ...living in Portugal and participating in wave 4 (W4) and wave 6 (W6) of the Survey of Health, Ageing and Retirement in Europe (SHARE) project was considered. Participants, 1765 at baseline (W4) and 1201 at follow up (W6), were asked about their quality of life (CASP-12) and emotional status (Euro-D scale; five items from the Beck Anxiety Inventory). Linear Mixed Effects models were performed to identify factors associated with changes in quality of life across age. Increasing age was found to have a significant negative effect on quality of life. Lower education and higher levels of depression and anxiety at baseline were also associated with worse quality of life; 42.1% of the variation of CASP-12 across age was explained by fixed and random effects, being depression followed by anxiety as the factors that presented with the highest relative importance. Both depression and anxiety play an important role in quality of life in older adults and must be acknowledged as important intervention domains to foster healthy and active aging.
ABSTRACT
Background
Non‐motor symptoms (NMS) are integral to Parkinson's disease (PD) and have a detrimental effect on patients and their caregivers. Clinical quantification has been aided by the ...development of comprehensive assessments such as the Non‐Motor Symptoms Questionnaire (NMSQuest) and Scale (NMSS). The NMSS has been widely used in clinical studies and trials; however, since its validation in 2007, our understanding of NMS has changed substantially. With the support of the International Parkinson and Movement Disorder Society (IPMDS), after a detailed peer review an initiative to develop an updated version of NMSS, the MDS‐NMS was launched in 2015.
Objective
This paper encapsulates the data from the pre‐validation phases carried out under the auspices of the IPMDS Non‐Motor PD Study Group.
Methods
Item selection and wording (formatted as a rater‐based tool) were based on the NMSS, literature review, and expert consensus. Neurologists, PD patients, and healthy controls were included in the cognitive pretesting and administration of the preliminary version of the MDS‐NMS. Primary data on acceptability and reliability were obtained.
Results
The pilot study, carried out in English in the United Kingdom and the United States, demonstrated that the preliminary version of the MDS‐NMS was comprehensive, understandable, and appropriate. Data quality was excellent; moderate floor effect was present in patients for most MDS‐MNS domains, with some components showing weak internal consistency. The results led to additional instrument modifications.
Conclusion
Qualitative and quantitative research results have led to an updated NMSS, the definitive version of the MDS‐NMS, which is currently being validated.
Background
The Living with Chronic Illness (LW‐CI) Scale is a comprehensive patient‐reported outcome measure that evaluates the complex process of living with long‐term conditions.
Objective
This ...study aimed to analyse the psychometric properties of the LW‐CI scale according to the classic test theory and the Rasch model among individuals living with different long‐term conditions.
Design
This was an observational, international and cross‐sectional study.
Methods
A total of 2753 people from six Spanish‐speaking countries living with type 2 diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure, Parkinson's disease, hypertension and osteoarthritis were included. The acceptability, internal consistency and validity of the LW‐CI scale were analysed using the classical test theory, and fit to the model, unidimensionality, person separation index, item local independency and differential item functioning were analysed using the Rasch model.
Results
Cronbach's α for the LW‐CI scale was .91, and correlation values for all domains of the LW‐CI scale ranged from .62 to .68, except for Domain 1, which showed correlation coefficients less than .30. The LW‐CI domains showed a good fit to the Rasch model, with unidimensionality, item local independency and moderate reliability providing scores in a true interval scale. Except for two items, the LW‐CI scale was free from bias by long‐term condition type.
Discussion
After some adjustments, the LW‐CI scale is a reliable and valid measure showing a good fit to the Rasch model and is ready for use in research and clinical practice. Future implementation studies are suggested.
Patient and Public Contribution
Patient and public involvement was conducted before this validation study ‐ in the pilot study phase.
The main objective was to identify sociodemographic characteristics of the population at risk for a greater clustering of unhealthy behaviors and to evaluate the association of such clustering with ...self-rated health status and disability. Data come from the 2017 Spanish National Health Survey with a sample of 21,947 participants of 15 years of age or older. Based on tobacco consumption, risk drinking, unbalanced diet, sedentarism, and body mass index <18.5/≥25 we created two indicators of risk factor clustering: 1) Number of unhealthy behaviors (0–5); and 2) Unhealthy lifestyle index (score: 0–15). Self-rated health was dichotomized into “optimal” and “suboptimal,” and disability was classified as “no disability,” “mild,” and “severe” based on the Global Activity Limitation Index (GALI). We estimated prevalence ratios (PR) adjusted for covariates using generalized linear models using the clustering count variable, and dose-response curves using the unhealthy lifestyle index. Most participants (77.4%) reported 2 or more risk factors, with men, middle-age individuals, and those with low socioeconomic status being more likely to do so. Compared to those with 0–1 risk factors, the PR for suboptimal health was 1.26 (95% CI:1.18–1.34) for those reporting 2–3 factors, reaching 1.43 (95% CI:1.31–1.55) for 4–5 factors. The PR for severe activity limitation was 1.66 (95% CI:1.35–2.03) for those reporting 2–3 factors and 2.06 (95% CI:1.59–2.67) for 4–5 factors. The prevalence of both health indicators increased in a non-linear fashion as the unhealthy lifestyle index score increased, increasing rapidly up to 5 points, slowing down between 5 and 10 points, and plateauing afterwards.
•Most participants, 3 out of 4 individuals, reported 2 or more risk factors•Clustering was more common in men, middle-age, with low educational level•Worse self-rated health increased as the number of risk behaviors accumulated•Clustering was associated with both physical and mental health limitations
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