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Parkinsonism Relat Disord. 2014 Mar;20(3):274-9. doi: 10.1016/j.parkreldis.2013.10.004. Epub 2013 Oct 16.

Mobility, mood and site of care impact health related quality of life in Parkinson's disease.

Author information

  • 1Oregon Health & Science University, USA. Electronic address:
  • 2University of Pennsylvania, USA.
  • 3University of Toronto, USA.
  • 4National Parkinson Foundation, USA.
  • 5University of Florida, USA.
  • 6National Parkinson Foundation, USA; University of Florida, USA.
  • 7Northwestern University, USA.
  • 8Struthers Parkinson Center, USA.
  • 9Vanderbilt University, USA.
  • 10Tel Aviv Sourasky Medical Center, USA.
  • 11University of South Florida, USA.
  • 12Baylor College of Medicine, USA.
  • 13University of Kansas, USA.
  • 14DeBakey Veterans Affairs Medical Center, USA.
  • 15Toronto Western University, USA.
  • 16Georgia Regents University, USA.
  • 17Muhammad Ali Parkinson Center, USA; Barrow Neurological Institute, USA.
  • 18Beth Israel Medical Center, USA.
  • 19Johns Hopkins Medical Center, USA.
  • 20Dartmouth-Hitchcock Medical Center, USA.



Examine the correlates of Health Related Quality of Life (HRQL) in a large cohort of Parkinson's disease (PD) patients from National Parkinson Foundation (NPF) Centers of Excellence (COEs).


Improving outcomes for PD will depend upon uncovering disease features impacting HRQL to identify targets for intervention and variables for risk-adjustment models. Differences in HRQL outcomes between COEs could uncover modifiable aspects of care delivery.


This cross-sectional study examined the relative contribution of demographic, social, clinical and treatment features potentially related to HRQL, as measured by the PDQ-39, in 4601 consecutive subjects from 18 COEs. Stepwise linear regression was utilized to identify correlates of HRQL.


The variability in the PDQ-39 summary index score correlated with H&Y stage (R(2) = 22%), Timed up and Go (TUG) (17%), disease duration (11%), comorbidities (8%), cognitive status (8%), antidepressant use (6%) and center at which a patient received care (5%). Stepwise regression reordered the importance of the variables, with the H&Y first and TUG and the center becoming equal and the second most important variables determining the PDQ-39 total score. All independent variables together accounted for 44% of the variability in HRQL.


We confirmed many but not all HRQL associations found in smaller studies. A novel observation was that the site of care was an important contributor to HRQL, suggesting that comparison of outcomes and processes among centers may identify best practices.

Copyright © 2013 Elsevier Ltd. All rights reserved.


Best practices; Health related quality of life; Parkinson's disease; Quality improvement

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