Quality of Life Research

, Volume 22, Issue 7, pp 1543–1553

Determinants of health-related quality of life in people with Parkinson’s disease: a path analysis

Authors

    • Physiotherapy DepartmentThe Alfred
    • Physiotherapy Department, School of Primary Health CareMonash University
  • Jennifer L. McGinley
    • Physiotherapy Department, Melbourne School of Health SciencesThe University of Melbourne
    • Clinical Research Centre for Movement Disorders and Gait, Kingston Centre Southern Health
  • Jennifer J. Watts
    • Centre for Health EconomicsMonash University
  • Robert Iansek
    • Clinical Research Centre for Movement Disorders and Gait, Kingston Centre Southern Health
  • Anna T. Murphy
    • Clinical Research Centre for Movement Disorders and Gait, Kingston Centre Southern Health
  • Hylton B. Menz
    • Lower Extremity and Gait Studies Program, Faculty of Health SciencesLa Trobe University
  • Frances Huxham
    • Clinical Research Centre for Movement Disorders and Gait, Kingston Centre Southern Health
  • Meg E. Morris
    • School of Allied Health, Faculty of Health SciencesLa Trobe University
Article

DOI: 10.1007/s11136-012-0289-1

Cite this article as:
Soh, S., McGinley, J.L., Watts, J.J. et al. Qual Life Res (2013) 22: 1543. doi:10.1007/s11136-012-0289-1

Abstract

Purpose

To identify the demographic factors, impairments and activity limitations that contribute to health-related quality of life (HRQOL) in people with idiopathic Parkinson’s disease (PD).

Method

Two hundred and ten individuals with idiopathic PD who participated in the baseline assessment of a randomized clinical trial were included. The Parkinson’s Disease Questionnaire-39 summary index was used to quantify HRQOL. In order to provide greater clarity regarding the determinants of HRQOL, path analysis was used to explore the relationships between the various predictors in relation to the functioning and disability framework of the International Classification of Functioning model.

Results

The two models of HRQOL that were examined in this study had a reasonable fit with the data. Activity limitations were found to be the strongest predictor of HRQOL. Limitations in performing self-care activities contributed the most to HRQOL in Model 1 (β = 0.38; p < 0.05), while limitations in functional mobility had the largest contribution in Model 2 (β = −0.31; p < 0.0005). Self-reported history of falls was also found to have a significant and direct relationship with HRQOL in both models (Model 1 β = −0.11; p < 0.05; Model 2 β = −0.21; p < 0.05).

Conclusions

Health-related quality of life in PD is associated with self-care limitations, mobility limitations, self-reported history of falls and disease duration. Understanding how these factors are inter-related may assist clinicians focus their assessments and develop strategies that aim to minimize the negative functional and social sequelae of this debilitating disease.

Keywords

Quality of lifeParkinson’s diseasePDQ-39DeterminantsPath analysis

Abbreviations

ADL

Activities of daily living

AIC

Akaike Information Criteria

CFI

Comparative fit index

FOG-Q

Freezing of Gait questionnaire

CI

Confidence interval

CNS

Central Nervous System

df

degrees of freedom

HBSMS

Heuristic Best Significant Model Search

HRQOL

Health-related quality of life

HY

Hoehn and Yahr

ICD-9-CM

International Classification of Diseases, Ninth Revision, Clinical Modification

ICF

International Classification of Functioning, Disability and Health

MDRS

Modified Dyskinesia Rating Scale

MMSE

Mini-Mental State Examination

PD

Parkinson’s disease

PDQ-39

Parkinson’s Disease Questionnaire-39

PDQ-39 SI

Parkinson’s Disease Questionnaire-39 Summary Index

RCT

Randomized controlled trial

RMSEA

Root mean square error of approximation

SD

Standard deviation

SEM

Structural equation modeling

SRMR

Standardized root mean square residual

TUGT

Timed “Up and Go Test”

UPDRS

Unified Parkinson’s Disease Rating Scale

Copyright information

© Springer Science+Business Media Dordrecht 2012