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Autonomic Dysfunction in PD and Its Effect on QOL

Mov Disord; ePub 2017 Dec 26; Merola, et al

The severity of autonomic symptoms in patients with Parkinson disease (PD) progressed by 20% over 1 year and was independently associated with impairments in daily living activities and health-related quality of life, a recent study found. Researchers recruited 131 consecutive patients into a 12-month, prospective, observational cohort study. Clinical measures included the International Parkinson and Movement Disorder Society/UPDRS, the Scale for Outcomes in Parkinson Disease-Autonomic, the Orthostatic Hypotension Symptoms Assessment, and orthostatic blood pressure measurements. They found:

  • The overall severity of autonomic symptoms, as measured by the Orthostatic Hypotension Symptoms Assessment total score, worsened by 20% over 12 months, with an overall increase in orthostatic hypotension prevalence from 31.1% to 46.7%.
  • Worsening of autonomic symptoms was independently associated with deterioration in daily living activities and health-related quality of life adjusting for disease duration, cognitive impairment, and motor severity.
  • Regardless of symptomatic status, orthostatic hypotension was associated with greater deterioration in daily living activities, health care utilization, and falls, compared to patients without orthostatic hypotension.

Merola A, Romagnolo A, Rosso M, et al. Autonomic dysfunction in Parkinson's disease: A prospective cohort study. [Published online ahead of print December 26, 2017]. Mov Disord. doi: 10.1002/mds.27268.

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