Objective: To determine whether clinical subtypes of Parkinson disease (PD) differ in health-related quality of life (QOL).

Background: Health-related QOL varies for individuals with PD. While more severe motor symptoms predict worse QOL, motor symptoms alone are insufficient to explain these differences [1]. We hypothesized that PD clinical subtypes, derived from comprehensive motor, psychiatric, and cognitive symptom profiles, would differ in health-related QOL. We also investigated whether PD subtypes provide predictive utility beyond other measures commonly associated with QOL in PD.

Method: A prospective cohort of 81 non-demented people (41% female) with PD completed baseline evaluations as part of a larger longitudinal study. Latent class analysis derived three subtypes: Motor Only (n=47), Psychiatric & Motor (n=9), and Cognitive & Motor (n=25). Participants completed questionnaires to assess psychosocial functioning and health-related QOL including the Parkinson’s Disease Questionnaire-39 (PDQ-39), Geriatric Depression Scale (GDS), Frontal Systems Behavior Scale (FRSBE) Apathy Scale, and Neuropsychiatric Inventory Questionnaire (NPIQ).

Results: After controlling for age, sex, education, and motor symptom duration, univariate analyses of variance (ANOVA) showed subtypes differed significantly in total PDQ-39 scores (p<0.001). Post hoc tests with Bonferroni correction revealed this difference was driven by significantly worse QOL for the Psychiatric & Motor group (all p’s<.001). Ratings for the PDQ domains of mobility, emotional wellbeing, social support, cognition, communication, and bodily discomfort also differed across subtypes (all p’s<0.01), with all effects driven by significantly worse QOL in the Psychiatric & Motor group. Hierarchical regression adding GDS, FRSBE Apathy, and NPIQ to the model indicated clinical subtypes did not significantly improve prediction of PDQ-39 total. GDS and motor symptom duration were the only significant predictors of QOL in the final model (both ps<.05).

Conclusion: The Psychiatric & Motor group reported worse QOL overall and across several domains compared to Motor Only and Cognitive & Motor. Consistent with prior research, depression and disease duration largely accounted for these differences. Future work should confirm these findings with a larger sample and investigate whether PD clinical subtypes predict longitudinal changes in QOL.

References: 1. Zhao N, Yang Y, Zhang L, Zhang Q, Balbuena L, Ungvari GS, Zang YF, Xiang YT. Quality of life in Parkinson’s disease: A systematic review and meta-analysis of comparative studies. CNS Neurosci Ther. 2021 Mar;27(3):270-279. doi: 10.1111/cns.13549. Epub 2020 Dec 28. PMID: 33372386; PMCID: PMC7871788.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-clinical-subtypes-differ-in-health-related-qol/