Objective: To investigate the longitudinal association of the UPDRS part I (mentation, behavior and mood), UPDRS part II (patient evaluation of activities of daily living (ADL) and part III (clinician-scored monitored motor evaluation) with patient-reported health-related quality of life (HRQoL) among individuals with Parkinson´s disease (PD).

Background: The cross-sectional association between the UPDRS and HRQoL in people with PD has been broadly described, but data on the longitudinal association are scarce.

Method: We analyzed data from the National Institute of Neurological Disorders and Stroke Exploratory Clinical Trials in Parkinson Disease Long-Term Study 1, a randomized, placebo-controlled trial of creatine (NET-PD LS-1). This study included people with early PD (diagnosis < 5 years) on dopaminergic therapy. Only people in the placebo arm were included in this analysis. The Parkinson’s Disease Questionnaire-39 (PDQ-39) summary index (SI) was used to assess patient-reported HRQoL. Assessments were performed annually; the current analysis includes five years of follow-up. We used linear mixed models with a random intercept to explore the longitudinal association between the UPDRS parts and PDQ-39, adjusted for age and sex, stratified by type of dopaminergic therapy (levodopa (LD) or dopamine agonists (DA)). Regression estimates (b) were standardized (per SD).

Results: In the current analysis we included 488 people with PD (35.2% women, mean (SD) age: 62.9 (9.2)), of which 248 individuals were receiving LD and 240 DA. Median (IQR) scores at baseline were: PDQ-39 SI : 9.9 (5.5-16.8), UPDRS Part I: 1 (0-2), UPDRS Part II: 6 (4-9), UPDRS Part III: 17 (12-24). Decline in all UPDRS parts was associated with decline on PDQ-39 over time, with the strongest association for Part II (LD: b= 0.38 (95% CI 0.33-0.43; DA: b=0.31 (0.26-0.36)), followed by Part I (LD: b= 0.25 (95% CI 0.21-0.29; DA: b=0.24 (0.20-0.28)) and Part III (LD: b= 0.07 (95% CI 0.02-0.12); DA: b=0.10 (0.05-0.14)).

Conclusion: We showed that decline on UPDRS scores was associated with decline in HRQoL in people with PD. In line with previous cross-sectional studies, over 5 years of follow-up the patient-reported UPDRS Parts I and II showed the strongest associations with the HRQoL, but also the clinician-rated Part III was associated with HRQoL over time.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-association-between-updrs-and-health-related-quality-of-life-in-people-with-parkinsons-disease/