Cross-Cultural Validity, Reliability, and Psychometric Properties of the Persian Version of the Scales for Outcomes in Parkinson’s Disease-Psychosocial Questionnaire

Objectives. Considering the influence of different motor and nonmotor features of Parkinson’s disease (PD), it is important to evaluate the psychosocial functioning of the patients. For this purpose, the scales for outcomes in Parkinson’s disease-psychosocial questionnaire (SCOPA-PS) has been previously designed. The aim of our study was to assess the cross-cultural validation and psychometric properties of the Persian version of the SCOPA-PS. Methods. One hundred and ten nondemented idiopathic Parkinson’s disease (IPD) patients were consecutively recruited from an outpatient referral movement disorder clinic. Eligible patients filled up a number of questionnaires including the Persian version of SCOPA-PS during the face-to-face interview session and clinical examination to measure disease severity, nonmotor psychiatric symptoms, and health-related quality of life (HRQoL). Results. The highest and lowest correlation coefficients of internal consistency were reported for item 7 on “asking for help” (r=0.765) and item 5 on “sexual problems” (r=0.553). Cronbach’s alpha reliability coefficient of the entire scale was 0.87 (95% CI: 0.83–0.90). The Hoehn and Yahr stage (r=0.34, P<0.001), Schwab and England ADL scale (r=-0.55, P<0.001), anxiety (r=0.64, P<0.001), depression (r=0.71, P<0.001), and fatigue (r=0.35, P<0.001) were significantly correlated with the total score of the SCOPA-PS questionnaire. Conclusions. The Persian version of SCOPA-PS is a highly reliable and valid scale to measure psychosocial functioning in IPD patients with different sex, age-group, and educational level, which could be applied in future researches. Disease severity scales, depression, anxiety, fatigue, and different domains of HRQoL were all associated with psychosocial functioning in PD patients

Heterogeneous Determinants of Quality of Life in Different Phenotypes of Parkinson’s Disease

<div><p>Objectives</p><p>Health-related quality of life (HRQoL) is considered a very important outcome indicator in patients with Parkinson’s disease (PD). A broad list of motor and non-motor features have been shown to affect HRQoL in PD, however, there is a dearth of information about the complexity of interrelationships between determinants of HRQoL in different PD phenotypes. We aimed to find independent determinates and the best structural model for HRQoL, also to investigate the heterogeneity in HRQoL between PD patients with different phenotypes regarding onset-age, progression rate and dominant symptom.</p><p>Methods</p><p>A broad spectrum of demographic, motor and non-motor characteristics were collected in 157 idiopathic PD patients, namely comorbidity profile, nutritional status, UPDRS (total items), psychiatric symptoms (depression, anxiety), fatigue and psychosocial functioning through physical examination, validated questionnaires and scales. Structural equation model (SEM) and multivariate regressions were applied to find determinants of Parkinson’s disease summary index (PDSI) and different domains of HRQoL (PDQ-39).</p><p>Results</p><p>Female sex, anxiety, depression and UPDRS-part II scores were the significant independent determinants of PDSI. A structural model consisting of global motor, global non-motor and co-morbidity indicator as three main components was able to predict 89% of the variance in HRQoL. In older-onset and slow-progression phenotypes, the motor domain showed smaller contribution on HRQoL and the majority of its effects were mediated through non-motor features. Comorbidity component was a significant determinant of HRQoL only among older-onset and non-tremor-dominant PD patients. Fatigue was not a significant indicator of non-motor component to affect HRQoL in rapid-progression PD.</p><p>Conclusions</p><p>Our findings showed outstanding heterogeneities in the pattern and determinants of HRQoL among PD phenotypes. These factors should be considered during the assessments and developing personalized interventions to improve HRQOL in PD patients with different phenotypes or prominent feature.</p></div

Univariate linear correlations between the baseline and clinical characteristics with Parkinson’s disease summary index (PDSI) of the health-related quality of life (HRQoL) (n = 157).

<p>PIGD: postural-instability-gait-difficulty; FOSS: freezing-speech-swallowing</p><p>* Statistical significant correlation (two-tailed <i>p</i>-value<0.05)</p><p>¹ Total number of comorbidities</p><p>² Score A is the sum of UPDRS-Part III items concerning facial expression, tremor, rigidity, and Bradykinesia which are considered relatively L-dopa responsive</p><p>³ Score B is the sum of UPDRS-Part III items concerning speech and axial impairment (arising from chair, posture, postural stability, gait) which are considered relatively L-dopa non-responsive.</p><p>Univariate linear correlations between the baseline and clinical characteristics with Parkinson’s disease summary index (PDSI) of the health-related quality of life (HRQoL) (n = 157).</p

Baseline and clinical characteristics of the Parkinson’s disease patients (n = 157).

<p>SD: standard deviation; IQR: interquartile range; PIGD: postural-instability-gait-difficulty; FOSS: freezing-speech-swallowing</p><p>¹ Score A is the sum of UPDRS-Part III items concerning facial expression, tremor, rigidity, and Bradykinesia which are considered relatively L-dopa responsive</p><p>² Score B is the sum of UPDRS-Part III items concerning speech and axial impairment (arising from chair, posture, postural stability, gait) which are considered relatively L-dopa non-responsive.</p><p>Baseline and clinical characteristics of the Parkinson’s disease patients (n = 157).</p

Structural equation model for the factors affecting health-related quality of life (HRQoL) in patients with Parkinson’s disease [all standardized regression weights are statistically significant at p<0.001 except for the effect of comorbidities on HRQoL (p = 0.045), the indication of motor domain on fluctuations (p = 0.062) and dyskinesia (p = 0.001), and the indication of HRQoL on stigma (p = 0.001)]

<p>Structural equation model for the factors affecting health-related quality of life (HRQoL) in patients with Parkinson’s disease [all standardized regression weights are statistically significant at p<0.001 except for the effect of comorbidities on HRQoL (p = 0.045), the indication of motor domain on fluctuations (p = 0.062) and dyskinesia (p = 0.001), and the indication of HRQoL on stigma (p = 0.001)]</p