The impact of levodopa therapy-induced complications on quality of life in Parkinson's disease patients in Singapore

Sci Rep. 2019 Jun 25;9(1):9248. doi: 10.1038/s41598-019-45110-5.

Abstract

The objective of this study was to investigate the impact of levodopa therapy-induced complications on the quality of life (QoL) of Parkinson's disease (PD) patients in Singapore over a 1-year follow-up period. 274 PD patients were prospectively recruited, of which 78 patients completed the follow-up. Patients were evaluated on: (1) motor symptoms, (2) non-motor symptoms, (3) levodopa therapy-induced complications and (4) QoL. Levodopa-induced complications including dyskinesia and OFF symptoms occurred in 13.5% and 55.9% of the study population, respectively. In patients who completed the 1-year follow-up, there was a trend suggestive of increasing dyskinesia duration, more disabling dyskinesia as well as longer, more sudden and unpredictable OFF periods. There was a significant decline in the overall QoL at follow-up, in particular, activities of daily living, emotional well-being, cognition and communication domains were the most affected. The multivariable analysis demonstrated that worsening of UPDRS IV total score over 1-year interval was associated with worsening in PDQ-Summary Index score (d = 0.671, p = 0.014). In conclusion, levodopa-induced complications had significant adverse impacts on QoL. This study substantiates the importance for clinicians to closely monitor and promptly manage levodopa therapy-induced complications that may arise in patients.

Publication types

  • Clinical Trial
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Antiparkinson Agents / adverse effects*
  • Dyskinesia, Drug-Induced / epidemiology*
  • Dyskinesia, Drug-Induced / etiology
  • Dyskinesia, Drug-Induced / pathology
  • Female
  • Humans
  • Incidence
  • Levodopa / adverse effects*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / pathology
  • Quality of Life*
  • Severity of Illness Index*
  • Singapore / epidemiology
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Levodopa