Staging Parkinson’s disease according to the MNCD classification correlates with caregiver burden

Malaltia de Parkinson; Cuidador; Símptomes no motorsParkinson's disease; Caregiver; Non-motor symptomsEnfermedad de Parkinson; Cuidador; Síntomas no motoresBackground and objective: Recently, we demonstrated that staging Parkinson's disease (PD) with a novel simple classification called MNCD, based on four axes (motor, non-motor, cognition, and dependency) and five stages, correlated with disease severity and patients’ quality of life. Here, we analyzed the correlation of MNCD staging with PD caregiver's status. Patients and methods: Data from the baseline visit of PD patients and their principal caregiver recruited from 35 centers in Spain from the COPPADIS cohort from January 2016 to November 2017 were used to apply the MNCD total score (from 0 to 12) and MNCD stages (from 1 to 5) in this cross-sectional analysis. Caregivers completed the Zarit Caregiver Burden Inventory (ZCBI), Caregiver Strain Index (CSI), Beck Depression Inventory-II (BDI-II), PQ-10, and EUROHIS-QOL 8-item index (EUROHIS-QOL8). Results: Two hundred and twenty-four PD patients (63 ± 9.6 years old; 61.2% males) and their caregivers (58.5 ± 12.1 years old; 67.9% females) were included. The frequency of MNCD stages was 1, 7.6%; 2, 58.9%; 3, 31.3%; and 4–5, 2.2%. A more advanced MNCD stage was associated with a higher score on the ZCBI (p < .0001) and CSI (p < .0001), and a lower score on the PQ-10 (p = .001), but no significant differences were observed in the BDI-II (p = .310) and EUROHIS-QOL8 (p = .133). Moderate correlations were observed between the MNCD total score and the ZCBI (r = .496; p < .0001), CSI (r = .433; p < .0001), and BDI-II (r = .306; p < .0001) in caregivers.Conclusion: Staging PD according to the MNCD classification is correlated with caregivers’ strain and burden.Fundación Española de Ayuda a la Investigación en Enfermedades Neurodegenerativas y/o de Origen Genético; Alpha Bioresearch; Spanish Ministry of Economy and Competitiveness, Grant/Award Number: PI16/0157

Symptom Severity in Early-stage Relapsing Remitting Multiple Sclerosis (P5-3.009)

Objective: The aim of this study was to assess the illness perception and associated factors in early-stage relapsing remitting multiple sclerosis (RRMS) patients. Background: Patients with early-stage RRMS experience uncertainty and intense emotions as diagnosis is disclosed. Illness perception at this point can influence levels of adjustment, coping strategies, and patients’ well-being. Design/Methods: A multicentre, non-interventional study was conducted. Adult patients with RRMS, disease duration ≤3 years, and Expanded Disability Status Scale (EDSS) score between 0–5.5 were included. The Brief-Illness Perception Questionnaire (B-IPQ) was used to assess patients’ cognitive and emotional illness representation. Patient-reported measures were administered to gather information on different outcomes. A multivariate logistic regression analysis was performed to assess the association between B-IPQ and demographic, clinical characteristics, and patients’ perspectives. Results: A total of 189 patients were included (mean age: 36.1±9.4 years, 71.4% female, mean disease duration: 1.4±0.8 years). Median EDSS score was 1.0 (IQR=0.0–2.0). A proportion of 36.5% (n=69/189) patients had a moderate-to-high threatening illness perception, and 45.5% of patients thought that their MS was caused by psychological factors. Bivariate analyses suggested that patients were significantly more likely to have a threatening disease perception if they were unemployed, received symptomatic treatment, had a higher EDSS, worse hand dexterity and gait, higher perception of pain, fatigue, symptom severity, hopelessness, and worse perception of their quality of life. Also patients that reported workplace barriers, cognitive complaints, and probable cases of anxiety, depression, and stigma. Higher EDSS, symptom severity, worse psychological quality of life, perception of stigma, and higher hopelessness-trait were predictors of moderate-to-high threatening illness perception (OR=2.349, 95%CI:1.276–5.130; OR=1.208, 95%CI:1.089–1.364; OR=1.051, 95%CI:1.018–1.089; OR=3.365, 95%CI:1.152–10.796; OR=41.177, 95%CI:6.942–388.825, respectively, all p<0.05). Conclusions: Threatening illness perceptions are common among patients with early RRMS. Identifying these beliefs and its associated factors and establishing individualized interventions may help patients deal with their condition