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Parkinsonism & related disorders
Nov, 2023;116 105892.

The effects of medical comorbidity, cognition, and age on patient-reported outcomes in Parkinson's disease.

Haesung Kim, Lisa M Shulman, Sunita Shakya, Ann Gruber-Baldini
Author Information
  1. Haesung Kim: Division of Gerontology, Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
  2. Lisa M Shulman: Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
  3. Sunita Shakya: Division of Gerontology, Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
  4. Ann Gruber-Baldini: Division of Gerontology, Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: abaldin@som.umaryland.edu.
PMID: 37837675 DOI: 10.1016/j.parkreldis.2023.105892

Abstract

OBJECTIVE: The purpose of this cross-sectional study was to compare the independent contributions of medical comorbidity, cognition, and age on patient-reported outcomes in Parkinson's disease (PD).
METHODS: 572 PD patients completed the Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v2.0 Profile (physical function, anxiety, depression, fatigue, sleep disturbance, satisfaction with participation in social roles, pain interference) and PROMIS Global Health (mental health and physical health) scales. Comorbidity was measured with the Cumulative Illness Rating Scale-Geriatric (CIRS-G) and cognition with the Montreal Cognitive Assessment (MoCA). Multiple regression models examined the 9 PROMIS measures as predicted by comorbidity, cognition, and age, adjusting for demographic and clinical characteristics (UPDRS and disease duration).
RESULTS: Comorbidity was associated with poorer outcomes in all nine PROMIS domains. Cognition was associated with two of nine domains: physical function and anxiety. Age was associated with five domains: anxiety, depression, sleep disturbance, satisfaction with participation in social roles, and global mental health. Comorbidity showed greater effects on all nine domains than cognition or age (higher standardized beta coefficients).
CONCLUSION: Medical comorbidity, cognition, and age have different impacts on patient-reported outcomes in PD. Medical comorbidity has a greater impact than either cognition or age on a range of patient-reported physical and mental health domains. Medical comorbidity is an important contributor to the patient's perspective of their physical and mental health.

Keywords

Age Cognition Comorbidity PROMIS-29 Parkinson's disease

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Grants

  1. R01 AG059651/NIA NIH HHS

MeSH Term

Humans
Aged
Depression
Parkinson Disease
Cross-Sectional Studies
Quality of Life
Comorbidity
Sleep Wake Disorders
Cognition
Patient Reported Outcome Measures
Journal Article

Word Cloud

Created with Highcharts 10.0.0cognitioncomorbidityagephysicalhealthpatient-reportedoutcomesdiseasementalComorbidityParkinson'sPDanxietyPROMISassociatedninedomainsMedicalmedicalfunctiondepressionsleepdisturbancesatisfactionparticipationsocialrolesCognitiondomains:AgegreatereffectsOBJECTIVE:purposecross-sectionalstudycompareindependentcontributionsMETHODS:572patientscompletedPatient-ReportedOutcomeMeasurementInformationSystemPROMIS®-29v20ProfilefatiguepaininterferenceGlobalHealthscalesmeasuredCumulativeIllnessRatingScale-GeriatricCIRS-GMontrealCognitiveAssessmentMoCAMultipleregressionmodelsexamined9measurespredictedadjustingdemographicclinicalcharacteristicsUPDRSdurationRESULTS:poorertwofiveglobalshowedhigherstandardizedbetacoefficientsCONCLUSION:differentimpactsimpacteitherrangeimportantcontributorpatient'sperspectivePROMIS-29

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