Non-motor symptoms in Thai Parkinson’s disease patients: Prevalence, manifestation and health related quality of life

Background & Objective: Non-Motor Symptoms (NMS) are common in Parkinson’s disease (PD). While prevalence of each NMS in Thai PD patients is unknown, these NMS might have an impact on patients’ wellbeing. The aim of this study is to identify the prevalence, pattern and impact of NMS on the quality of life in Thai PD patients. Methods: A cross-sectional study in 115 PD patients was conducted at Thammasat University hospital. Subtype of PD, Schwab & England activity of daily living (ADL scale), Unified Parkinson’s Disease Rating Scale (UPDRS) motor score and the modified Hoehn & Yahr (H&Y scale) were recorded. NMS and quality of life were assessed using Thammasat University Non-Motor Symptoms Questionnaire (TU-NMSQuest) and Parkinson’s Disease Questionnaire-8 (PDQ-8). Results: All patients reported at least one NMS. A mean number of 15.94 ± 6.48 NMS was reported by each patient. Nocturia (79.1%), urinary urgency (73%), and fatigue (71.3%) were the most prevalent NMS. Significant correlations were observed between TU-NMSQuest and UPDRS motor score, H&Y scale, ADL scale, subtype of PD, and PDQ-8. Conclusion: NMS are common and have a significant impact on the quality of life in PD patients. Advanced disease stage, poorer motor or ADL function, and non-tremor dominant subtype are associated with a higher number of NMS and lower quality of life in Thai PD patients. Neurology Asia 2014; 19(2) : 163 – 170 Address correspondence to: Praween Lolekha, MD. MSc., 35/50 Noble House, Phayathai road, Rachjathavee, Bangkok, 10400, Thailand. Tel: 081-4461487, Fax: 02-9629794, E-mail: [email protected] INTRODUCTION Parkinson’s disease (PD) is the second most common neurodegenerative disorder that affects about 1-2% of elderly population with the age over 60 years old. The prevalence of PD is expected to increase significantly with ageing of the population. Recent study in Thailand showed the prevalence of 0.24%, which means approximately 170 thousand Thai citizens now live with PD. PD has a highly clinical heterogeneity and various clinical symptoms. The most recognized symptoms, known as “motor symptoms” are; resting tremor, bradykinesia, rigidity and postural instability. There are more symptoms of PD that both physicians and patients are often underrecognized in clinical practice. These symptoms are called as “non-motor symptoms”, including various types of autonomic symptoms, cognitive impairment, neuropsychiatric symptoms, pain and sleep disorders.3,4 Non-Motor Symptoms (NMS) are usually left untreated and most PD patients continue to suffer from these symptoms. As the average age and life expectancy of the population increases, the NMS of PD patients become increasingly important. The aim of this study is to identify the prevalence of Non-Motor Symptoms and the impact on the quality of life in Thai PD patients.