Objective: To examine what extent non-motor symptoms of Parkinson’s disease (PD) predict care dependence in individuals with PD.

Background: The main aim of medical management in PD is to preserve functional ability and ameliorate the impact of the disease on the quality of life. However, as the disease progresses, individuals with PD will gradually need assistance in performing daily activities. Both motor and non-motor impairments can impact activities of daily living (ADL) and potentially contribute to the level of assistance needed by an individual. While motor impairment (e.g. slowness, stiffness, tremor, and instability) directly worsens ability to perform daily functions, the non-motor symptoms can indirectly impact functional ability. Recently, there has been a growing interest of negative impact of non-motor symptoms on quality of life in individual with PD. However, research specific to non-motor symptoms and level of care in individuals with PD is still limited.

Methods: Cross sectional design was used. Participants were eighty-six individuals with PD. Their mean age was 69.63 ± 8.77 years. The average time since diagnosis was 8.06 ± 5.13 years. There were 64 male (74.4%) in the study sample.  Age, gender, disease duration, disease severity activities of daily living (ADL), motor impairment and non-motor symptoms including fatigue, sleepiness and depression were measured. Care dependency was classified into ‘entirely dependent’ and ‘not entirely dependent’ based on a response to a question on the level of care.

Results: Twenty-seven individuals were care independence and 59 were care dependence. Care dependence individuals had more severe disease severity, higher ADL dysfunction, higher degree of motor impairment and higher level of depression than the care independence. The results showed that depression was the only non-motor symptom associated with care dependence (OR=1.20, 95% CI=1.06). The effect held (OR=1.18, 95% CI=1.02, 1.36) after adjusting for clinical and motor impairment variables. The area under the curve (AUC) was 0.763 (95% CI: 0.65, 0.87) for a base model with clinical and motor impairment variables as predictors of care dependence. Adding non-motor symptoms in the model increased the AUC to 0.810 (95% CI: 0.72, 0.90).

Conclusions: Clinical assessment of depression may be useful in predicting care level need in individuals with PD.

References: 1. Chaudhuri KR, Schapira AH: Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol 2009; 8: 464–474.

2. Prakash KM, Nadkarni NV, Lye WK, Yong MH, Tan EK. The impact of non-motor symptoms on the quality of life of Parkinson’s disease patients: a longitudinal study. Eur J Neurol 2016;23(5):854-60.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/investigation-of-non-motor-symptoms-impacting-care-dependency-in-individuals-with-parkinsons-disease/