Fatigue, mood disorders and sleep problems in patients with Parkinson's disease
(2008) Eva Havlikova, MD
Promotor: Prof. Dr. J.W. Groothoff
Copromotor: Assoc. Prof. Dr. J.P. van Dijk, Dr. J. Rosenberger, Assoc. Prof. Dr. Z. Gdovinova, Dr. L. J. Middel
Parkinson’s disease (PD) is a slowly progressive disease characterized by its motor and only recently recognized nonmotor features. This thesis focuses on fatigue, sleep problems and mood disorders, on the relationships between these nonmotor features and their impact on quality of life (QoL) of PD patients. QoL has become one of the most important measures and constructs for evaluating more comprehensively the outcomes of a chronic disease. Previous research in this fi eld has mostly been oriented on descriptive data showing that PD patients report worse QoL than the general population. Later determinants of worse QoL were studied, with an interest in typical motor problems and sociodemographic variables. For this reason the Global Parkinson’s Disease Survey Committee was established in 2002. The results of this multinational cross-sectional study showed worse disease severity, a medication regime with only L-dopa and the presence of depression to signifi cantly worsen QoL. This study was thus the fi rst to evaluate the infl uence of nonmotor PD features on QoL. Recent research has also shown that the motor complications of L-dopa, pain or cognitive decline can worsen QoL.