The importance of educational and psychological factors in Parkinson's disease quality of life

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Abstract
Objective: To define the factors correlated with quality of life (QoL) in patients with idiopathic Parkinson's disease (PD). Background: PD has a substantial impact on QoL. Although several clinical factors have been associated with QoL in PD, the influence of patient's education still remains controversial. Methodology: A consecutive series of patients with PD were examined using the unified Parkinson's Disease Rating Scale (UPDRS part I, II, III), Schwab and England (SE), and Hoehn and Yahr stage (H&Y). QoL was rated with the PDQ‐39, cognition with the Mini‐Mental State examination (MMSE), and the presence of depressive symptoms with the geriatric depression scale (GDS). Patient's characteristics, estimated cumulative levodopa dose (CLD), UPDRS, H&Y, MMSE and GDS were correlated with the PDQ‐39 using univariate and multiple regression analysis. Results: A total of one hundred 58 patients (68 men, 90 women) with a mean age of 65.6 ± 9.3 years, PD duration of 8.1 ± 10.6 years, and education of 6.6 ± 3.9 years were included. The mean PDQ‐39 was 48.8 ± 27.8, mean MMSE was 25.7 ± 4, and mean GDS was 11.7 ± 6.8. Using stepwise multiple regression analysis, the most important predictive factors were depression, UPDRS part I, UPDRS part II, and educational background, which accounted for a 61% of the variability of the PDQ‐39 scores. Conclusions: In our PD sample, educational, behavioural, and psychological factors influenced life satisfaction more than physical ones.