SAN DIEGO – Atypical Parkinson's disease took the most profound toll on patients' ability to carry out essential daily activities among six chronic neurologic disorders evaluated in a study of disability and quality of life.
Lisa M. Shulman, M.D., codirector of the Parkinson's Disease and Movement Disorders Center at the University of Maryland in Baltimore, reported on the relative impact of six diverse movement and memory disorders on patients' daily lives.
She reported her results in poster form at the annual meeting of the American Neurological Association.
Significant variation was found in the disability and quality of life scores among patients with essential tremor (n = 58), dystonia (n = 50), Parkinson's disease (n = 425), psychogenic movement disorders (n = 34), Alzheimer's disease (n = 17), and atypical Parkinsonism (n = 45).
All of the disorders significantly undermined physical quality of life, as measured by the SF-12v2 Health Survey, but the patients with atypical Parkinson's disease had the lowest scores by far, reported Dr. Shulman and her associates from the university's department of neurology.
Just three of the disorders–Alzheimer's disease, psychogenic movement disorders, and atypical Parkinson's disease–showed reductions in mental health quality of life scores measured by the SF-12v2 survey.
Disability was assessed using the Older Americans Resources and Services scale, which includes activities of daily living (ADL) and instrumental activities of daily living (IADL) at a person's best and worst level of function.
Activities of daily living include basic functions such as eating, bathing, grooming, and continence, whereas instrumental activities of daily living include more complex tasks such as using the telephone, paying bills, preparing meals, and using transportation.
“Atypical Parkinson's disease has the greatest impact on all individual ADLs,” the investigators concluded.
Atypical Parkinson's disease and Alzheimer's disease had the greatest impact on all instrumental activities of daily living.
In general, neurodegenerative disorders (Parkinson's disease and atypical Parkinson's disease, and Alzheimer's disease) resulted in greater disability than disorders, such as essential tremor and dystonia.
The youngest patient group, those with psychogenic movement disorders (including tremor, myoclonus, and related conditions), had a mean age of 48.
Interestingly, this group reported similar or worse disability and physical quality of life scores as patients with Parkinson's disease (mean age 67), dystonia (mean age 62), and essential tremor (mean age 62).
Their scores on mental quality of life were comparable with those of patients with Alzheimer's disease (mean age, 74) or atypical Parkinson's disease (mean age 71).