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1.
Int J Geriatr Psychiatry ; 36(5): 627-646, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33169885

RESUMO

BACKGROUND: Although depression is known to be frequent in Parkinson's disease (PD), it is unclear how mood can change and/or impact on patient's quality of life (QoL) over time. Our aim was to analyze the frequency of depression, mood related factors and the contribution of mood to a patient's QoL perception in regard to disease duration. METHODS: PD patients recruited from the COPPADIS cohort from January 2016 to November 2017 were included in this cross-sectional study. Three groups were defined: <5 years (Group A); from 5 to <10 years (Group B); ≥10 years (Group C). Analysis with well-planned linear regression models was conducted to determine how different factors contribute to mood (Beck Depression Inventory-II [BDI-II] as dependent variable), to health-related QoL (39-item Parkinson's Disease Questionnaire [PDQ-39SI] as dependent variable) and to global QoL (European Health Interview Survey - Quality of Life Eight-Item Index [EUROHIS-QOL8] as dependent variable). RESULTS: Six hundred and sixty-three PD patients (62.6 ± 8.9 years old, 59.6% males) were included: Group A, 50.1% (n = 332); Group B, 33.3% (n = 221) and Group C, 16.6% (n = 110). There were no differences between the three groups in terms of the frequency of depressive symptoms nor the frequency of depression type (major vs. minor vs. subthreshold) (p = 0.729). However, the unique percent variance of PDQ-39SI and EUROHIS-QOL8 explained by BDI-II total score was 2 (23.7%) and threefold (26.9%), respectively, in Group C compared to the other two groups. EUROHIS-QOL8 total score provided the highest unique contribution to mood (16.8%). CONCLUSIONS: Although depression-type frequency does not appear to change over time in PD; the contribution of mood on QoL perception is greater in patients with longer disease duration.


Assuntos
Doença de Parkinson , Idoso , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Doença de Parkinson/epidemiologia , Qualidade de Vida , Inquéritos e Questionários
2.
Eur J Neurol ; 26(11): 1399-1407, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31179586

RESUMO

BACKGROUND AND PURPOSE: In Parkinson's disease (PD), the course of the disorder is highly variable between patients. Well-designed, prospective studies for identifying PD progression biomarkers are necessary. Our aim was to show the results of baseline evaluations of an ongoing global PD project, COPPADIS-2015 (Cohort of Patients with PArkinson's DIsease in Spain, 2015). METHODS: This was an observational, descriptive, nationwide study (Spain). The recruitment period ended in October 2017. Baseline evaluation included more than 15 validated scales and complementary studies in a subgroup of participants. RESULTS: In total, 1174 subjects from 35 centres were considered valid for baseline analysis: 694 patients (62.6 ± 8.9 years old, 60.3% males), 273 caregivers (58.5 ± 11.9 years old, 31.8% males) and 207 controls (61 ± 8.3 years old, 49.5% males). The mean disease duration was 5.5 ± 4.4 years. Hoehn and Yahr stage was 1 or 2 in 90.7% of the patients whilst 33.9% and 18.1% of them presented motor fluctuations and dyskinesias, respectively. The mean Non-Motor Symptoms Scale total score was 45.4 ± 38.1, and 30.4% of the patients presented cognitive impairment, 16.1% major depression, 12.7% impulse control disorder, 7.2% compulsive behaviour, 57.2% pain and 13.2% falls. Compared to the control group, PD patients presented a significantly higher burden of non-motor symptoms and a worse quality of life. More than 300 subjects conducted complementary studies (serum biomarkers, genetic and neuroimaging). CONCLUSIONS: Parkinson's disease is a complex disorder and different non-motor symptoms are frequently present and are more prevalent than in controls. In real clinical practice it is important to ask for them.


Assuntos
Doença de Parkinson/patologia , Idoso , Idoso de 80 Anos ou mais , Cuidadores/estatística & dados numéricos , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/etiologia , Estudos de Coortes , Comorbidade , Progressão da Doença , Transtornos Disruptivos, de Controle do Impulso e da Conduta , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Transtornos dos Movimentos/epidemiologia , Transtornos dos Movimentos/etiologia , Doença de Parkinson/epidemiologia , Doença de Parkinson/psicologia , Estudos Prospectivos , Qualidade de Vida , Fatores Socioeconômicos , Espanha/epidemiologia
3.
Neurologia ; 26(5): 285-90, 2011 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-21353345

RESUMO

INTRODUCTION: The Lennox-Gastaut syndrome (LGS) is one of the most severe epileptic encephalopathies of childhood, characterized by electro-clinical triad of generalized spike-wave activity, slow (POL) in the electroencephalogram (EEG), multiple types of seizures and development delay. This paper intends to describe the syndrome in a patient with a history of hypoxic-ischaemic encephalopathy and Lennox-Gastaut syndrome, and a good response to treatment with levetiracetam (LEV). METHOD: Descriptive study on the development of a 3 year old child with intrauterine asphyxia, multiorgan failure, metabolic acidosis, hypovolemic shock, and seizures with cerebral oedema, who developed a West syndrome, resistant to drug treatment. The semiology of seizures progressively changed to generalized episodes of hypertonia and myoclonus, with slow spike-wave electroencephalographic activity. RESULTS: With the diagnosis of Lennox-Gastaut syndrome the patient was treated with levetiracetam, showing a substantial improvement in the cognitive sphere, in the control of seizures, and electroencephalographic findings. CONCLUSIONS: Lennox-Gastaut syndrome is one of the most severe epileptic syndromes in paediatric patients. Levetiracetam can help cognitive improvement, and contribute to seizure control in these patients.


Assuntos
Anticonvulsivantes/uso terapêutico , Deficiência Intelectual/tratamento farmacológico , Piracetam/análogos & derivados , Espasmos Infantis/tratamento farmacológico , Pré-Escolar , Humanos , Síndrome de Lennox-Gastaut , Levetiracetam , Masculino , Piracetam/uso terapêutico
4.
Neurologia (Engl Ed) ; 36(1): 39-49, 2021.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29249303

RESUMO

INTRODUCTION: Knowledge of the socioeconomic impact of dementia-related disorders is essential for appropriate management of healthcare resources and for raising social awareness. METHODS: We performed a literature review of the published evidence on the epidemiology, morbidity, mortality, associated disability and dependence, and economic impact of dementia and Alzheimer disease (AD) in Spain. CONCLUSIONS: Most population studies of patients older than 65 report prevalence rates ranging from 4% to 9%. Prevalence of dementia and AD is higher in women for nearly every age group. AD is the most common cause of dementia (50%-70% of all cases). Dementia is associated with increased morbidity, mortality, disability, and dependence, and results in a considerable decrease in quality of life and survival. Around 80% of all patients with dementia are cared for by their families, which cover a mean of 87% of the total economic cost, resulting in considerable economic and health burden on caregivers and loss of quality of life. The economic impact of dementia is huge and difficult to evaluate due to the combination of direct and indirect costs. More comprehensive programmes should be developed and resources dedicated to research, prevention, early diagnosis, multidimensional treatment, and multidisciplinary management of these patients in order to reduce the health, social, and economic burden of dementia.


Assuntos
Doença de Alzheimer , Habilidades Sociais , Doença de Alzheimer/epidemiologia , Encéfalo , Cuidadores , Feminino , Humanos , Qualidade de Vida
5.
J Neurol Sci ; 418: 117109, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-32927370

RESUMO

BACKGROUND: The role of subthreshold depression (subD) in Parkinson's Disease (PD) is not clear. The present study aimed to compare the quality of life (QoL) in PD patients with subD vs patients with no depressive disorder (nonD). Factors related to subD were identified. MATERIAL AND METHODS: PD patients and controls recruited from the COPPADIS cohort were included. SubD was defined as Judd criteria. The 39-item Parkinson's disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8) were used to assess QoL. RESULTS: The frequency of depressive symptoms was higher in PD patients (n = 694) than in controls (n = 207) (p < 0.0001): major depression, 16.1% vs 7.8%; minor depression, 16.7% vs 7.3%; subD, 17.4% vs 5.8%. Both health-related QoL (PDQ-39; 18.1 ±â€¯12.8 vs 11.6 ±â€¯10; p < 0.0001) and global QoL (EUROHIS-QOL8; 3.7 ±â€¯0.5 vs 4 ±â€¯0.5; p < 0.0001) were significantly worse in subD (n = 120) than nonD (n = 348) PD patients. Non-motor Symptoms Scale (NMSS) total score was higher in subD patients (45.9 ±â€¯32 vs 29.1 ±â€¯25.8;p < 0.0001). Non-motor symptoms burden (NMSS;OR = 1.019;95%CI 1.011-1.028; p < 0.0001), neuropsychiatric symptoms (NPI; OR = 1.091; 95%CI 1.045-1.139; p < 0.0001), impulse control behaviors (QUIP-RS; OR = 1.035; 95%CI 1.007-1063; p = 0.013), quality of sleep (PDSS; OR = 0.991; 95%CI 0.983-0.999; p = 0.042), and fatigue (VAFS-physical; OR = 1.185; 95%CI 1.086-1.293; p < 0.0001; VAFS-mental; OR = 1.164; 95%CI 1.058-1.280; p = 0.0001) were related to subD after adjustment to age, disease duration, daily equivalent levodopa dose, motor status (UPDRS-III), and living alone. CONCLUSIONS: SubD is a frequent problem in patients with PD and is more prevalent in these patients than in controls. QoL is worse and non-motor symptoms burden is greater in subD PD patients.


Assuntos
Doença de Parkinson , Qualidade de Vida , Depressão/epidemiologia , Depressão/etiologia , Fadiga/epidemiologia , Fadiga/etiologia , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/epidemiologia , Inquéritos e Questionários
6.
Rev Neurol ; 49(8): 393-8, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19816841

RESUMO

AIM: To perform an independent evaluation of the psychometric attributes of the Parkinson's Disease-Cognitive Rating Scale (PD-CRS). PATIENTS AND METHODS: The study involved patients with Parkinson's disease (PD) free of any impediments preventing them from participating in the required evaluation. Sociodemographic and historical data were collected for use in this observational, cross-sectional study and the following evaluations were employed: Scales for Outcomes in Parkinson's Disease-Motor Scale (SCOPA-Motor), Hoehn and Yahr staging (HY), Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), Minimental State Examination (MMSE), SCOPA-Cognitive (SCOPA-Cog), Non-Motor Symptoms Questionnaire and PD-CRS. Acceptability, internal consistence, construct validity and precision of the PD-CRS were analysed. RESULTS: The sample consisted of 50 patients, with a mean age of 63.6 +/- 9.3 years. In all, 66% were males, with a history of 9 +/- 5.7 years with PD, in HY stages 1 to 4. Twelve patients (24%) presented data suggestive of dementia. The PD-CRS score was: sub-cortical sub-scale: 60.9 +/- 16.5; cortical sub-scale: 27.9 +/- 4.4; and total PD-CRS: 88.7 +/- 19.8. The mean-median difference was < 10% of the maximum scores and the total score showed no ceiling or floor effect. Cronbach's alpha was 0.85; the item-total correlations ranged from 0.57 (naming) to 0.73 (working memory), and the homogeneity index of the items was 0.36. Correlation with the MMSE and the SCOPA-Cog was high (rS = 0.53 and 0.77). The PD-CRS score was significantly lower in patients with a low level of schooling and more severe PD according to levels on the CISI-PD and distinguished between patients with and without dementia (70.3 +/- 26.2 versus 94.5 +/- 13; p < 0.001. The standard error of the measurement was 1.98. CONCLUSIONS: The levels of acceptability, internal consistence, construct validity and precision displayed by the PD-CRS were satisfactory.


Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Doença de Parkinson/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Inquéritos e Questionários
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